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1
Diabetic retinopathy (DR) is a leading cause of vision loss and is increasingly recognized as a neurovascular degenerative disorder.
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2
The retinal neurovascular unit (NVU) consists of neurons, glial cells, vascular cells, and extracellular matrix, coordinating neuronal activity and blood flow.
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3
Chronic hyperglycemia and other factors disrupt NVU interactions, leading to neurovascular uncoupling and early retinal dysfunction before visible lesions.
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4
Current therapies include anti-VEGF agents and corticosteroids, with emerging strategies targeting oxidative stress, inflammation, and neuroprotection.
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5
Reframing DR as a disorder of early NVU uncoupling may shift clinical focus from late vascular rescue to mechanism-based neurovascular protection.
