Abstract
BACKGROUND: Ocular Immune Diseases (OID) are a heterogeneous group of disorders characterized by immune-mediated inflammatory responses affecting various parts of the eye. OID encompass infectious forms caused by pathogens and non-infectious forms driven by immune dysregulation, which may occur as isolated ocular conditions or as part of systemic diseases. Nonspecific early symptoms often lead to misdiagnosis and significant risks of visual impairment. The unclear etiology and pathogenesis of OID present challenges in achieving effective treatments. Metabolomics, a cutting-edge omics tool, provides critical insights into disease-relevant phenotypes and advancing the understanding of OID. AIM OF REVIEW: This review synthesizes recent advancements in metabolomics, focusing on methodologies and sample sources for comprehensive profiling. It provides a holistic overview of metabolomics applications in OID, including keratitis, conjunctivitis, dry eye disease, scleritis, uveitis, and thyroid eye disease. Additionally, it discusses current limitations and outlines future directions for improving precision diagnostic and therapeutic strategies. KEY SCIENTIFIC CONCEPTS OF REVIEW: Metabolomic studies have identified distinct metabolic signatures in biofluids and tissues, bridging localized ocular inflammation with systemic immune dysregulation in OID. Perturbations in energy, lipid, and amino acid metabolism, oxidative stress regulation, and gut-derived metabolites highlight the metabolic reprogramming in OID. These findings enable the discovery of novel biomarkers, deeper insights into disease mechanisms, and the development of targeted therapies. As metabolomics evolves, it holds substantial promise for advancing precision medicine and optimizing outcomes in OID.