Future research should validate these findings in larger cohorts and conduct additional in vitro and in vivo experiments, including gene knockdown or overexpression in retinal endothelial cells and diabetic mouse models, to comprehensively elucidate the specific roles of HMOX1, TLR4, and ACE in the pathogenesis of diabetic retinopathy. This evidence concerns the gene HMOX1 and diabetic retinopathy.