{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T11:06:49Z","timestamp":1790593609730,"version":"4.1.0"},"reference-count":82,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Diabetic retinopathy (DR) has long been regarded as an isolated retinal microvascular disease. Histopathological, molecular, imaging, and multi-omics evidence now supports disruption of retinal neurovascular unit (NVU) homeostasis as a central mechanism of DR, in which neuronal degeneration, reactive gliosis, and microvascular damage reinforce one another. This narrative review summarizes the anatomy and physiology of the NVU, its temporal evolution in DR, the molecular pathways of neurovascular crosstalk, quantitative imaging assessment, and integrated therapeutic strategies, and indicates where the evidence remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, and Web of Science were searched from inception to July 2026 for reports on the retinal NVU in diabetes, and reference lists of retrieved articles were screened. Because this is a narrative rather than a systematic review, records were screened by the authors without a formal risk-of-bias assessment or quantitative synthesis. English-language reports addressing retinal NVU structure, diabetes-related injury mechanisms, imaging quantification, or NVU-directed interventions were eligible, and priority was given to human histopathological studies, prospective imaging cohorts, and translational intervention studies. Eighty-two references were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key findings<\/jats:title>\n                    <jats:p>\n                      Neurodegeneration is the earliest readily detectable change of NVU dysfunction in most cohorts, whereas microvascular injury amplifies retinal damage. Combined optical coherence tomography (OCT), OCT angiography (OCTA), and electroretinography (ERG) allow stage-specific quantification, and ganglion cell\u2013inner plexiform layer (GCIPL) and deep capillary plexus vessel density (DVD) are among the most consistently reported early markers, although this evidence varies. Polyol pathway activation, AGE\u2013RAGE and protein kinase C signaling, oxidative stress, HIF-1\n                      <jats:italic>\u03b1<\/jats:italic>\n                      \/vascular endothelial growth factor (VEGF) signaling, microglial STING and inflammasome activation, and non-coding RNA dysregulation jointly mediate bidirectional neurovascular injury. Vascular-targeted monotherapy cannot halt inner retinal neuronal loss, whereas multi-target strategies remain largely preclinical or at an early trial stage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In our interpretation, early neurodegeneration is the most readily detectable biomarker, microcirculatory damage acts as a disease amplifier, and complete NVU disintegration is the terminal common pathway. This framework is proposed to support ultra-early risk stratification and synergistic multi-target intervention, and is offered as one interpretation of a still-evolving evidence base rather than an established consensus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1966747","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:53:39Z","timestamp":1790592819000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diabetic retinal neurovascular unit injury: mechanisms, imaging evaluation, and integrated therapeutic strategies"],"prefix":"10.3389","volume":"13","author":[{"given":"Hui","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Rehabilitation Medicine Center, Zhejiang Provincial People\u2019s Hospital, Affiliated People\u2019s Hospital of Hangzhou Medical College","place":["Hangzhou, Zhejiang, China"]},{"name":"Department of Ophthalmology and Otorhinolaryngology, Haixi Prefecture People\u2019s Hospital","place":["Delingha, Qinghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Rehabilitation Medicine Center, Zhejiang Provincial People\u2019s Hospital, Affiliated People\u2019s Hospital of Hangzhou Medical College","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Rehabilitation Medicine Center, Zhejiang Provincial People\u2019s Hospital, Affiliated People\u2019s Hospital of Hangzhou Medical College","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongbo","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Rehabilitation Medicine Center, Zhejiang Provincial People\u2019s Hospital, Affiliated People\u2019s Hospital of Hangzhou Medical College","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/S2213-8587(25)00299-2","article-title":"11th Edition of the IDF diabetes atlas: global, regional, and national diabetes prevalence estimates for 2024 and projections for 2050","volume":"14","author":"Genitsaridi","year":"2026","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1001\/jamaophthalmol.2023.6435","article-title":"Diabetic retinopathy and quality of life: a systematic review and meta-analysis","volume":"142","author":"Zayed","year":"2024","journal-title":"JAMA Ophthalmol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"412","DOI":"10.2337\/dc16-2641","article-title":"Diabetic retinopathy: a position statement by the American diabetes association","volume":"40","author":"Solomon","year":"2017","journal-title":"Diabetes Care"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1659","DOI":"10.2147\/OPTH.S304229","article-title":"Visual function for driving in diabetic macular edema and retinal vein occlusion post-stabilization with anti-vascular endothelial growth factor","volume":"15","author":"Nixon","year":"2021","journal-title":"Clin Ophthalmol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1167\/iovs.14-15503","article-title":"Correlation between ganglion cell layer thinning and poor visual function after resolution of diabetic macular edema","volume":"56","author":"Bonnin","year":"2015","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"B6","doi-asserted-by":"publisher","first-page":"20","DOI":"10.4103\/djo.djo_51_24","article-title":"Changes of retinal ganglion cell-inner plexiform layer thickness and visual acuity in patients with diabetic macular edema treated with aflibercept","volume":"26","author":"Alsaad","year":"2025","journal-title":"Delta J Ophthalmol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"E2655","DOI":"10.1073\/pnas.1522014113","article-title":"Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus","volume":"113","author":"Sohn","year":"2016","journal-title":"Proc Natl Acad Sci USA"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1063","DOI":"10.1007\/s00592-023-02086-z","article-title":"Early diagnosis of retinal neurovascular injury in diabetic patients without retinopathy by quantitative analysis of OCT and OCTA","volume":"60","author":"Li","year":"2023","journal-title":"Acta Diabetol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1883","DOI":"10.2337\/db24-0107","article-title":"Deciphering the connection between microvascular damage and neurodegeneration in early diabetic retinopathy","volume":"73","author":"Yang","year":"2024","journal-title":"Diabetes"},{"key":"B10","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.ajo.2025.09.025","article-title":"Longitudinal neural and microvascular changes in type 2 diabetic patients without retinopathy: a 2-year prospective cohort study","volume":"281","author":"Fan","year":"2026","journal-title":"Am J Ophthalmol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1016\/j.ajo.2024.02.034","article-title":"Macular neural and microvascular alterations in type 2 diabetes without retinopathy: a SS-OCT study","volume":"262","author":"Dai","year":"2024","journal-title":"Am J Ophthalmol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2899","DOI":"10.1007\/s00125-025-06554-9","article-title":"3D Electron microscopy reveals novel ultrastructural changes in the diabetic retinal neurovascular unit","volume":"68","author":"Albargothy","year":"2025","journal-title":"Diabetologia"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1791","DOI":"10.2337\/dbi24-0036","article-title":"Dissecting the neurovascular unit in human diabetic retinal disease","volume":"73","author":"Gardner","year":"2024","journal-title":"Diabetes"},{"key":"B14","doi-asserted-by":"publisher","first-page":"8796","DOI":"10.3390\/ijms24108796","article-title":"Inflammation: the link between neural and vascular impairment in the diabetic retina and therapeutic implications","volume":"24","author":"Ramos","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B15","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1111\/ceo.12530","article-title":"Neuronal activity-dependent regulation of retinal blood flow","volume":"43","author":"Noonan","year":"2015","journal-title":"Clin Exp Ophthalmol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.visres.2017.03.003","article-title":"Diabetic retinopathy is a neurodegenerative disorder","volume":"139","author":"Lynch","year":"2017","journal-title":"Vision Res"},{"key":"B17","doi-asserted-by":"publisher","first-page":"101349","DOI":"10.1016\/j.preteyeres.2025.101349","article-title":"Microglial regulation of the retinal vasculature in health and during the pathology associated with diabetes","volume":"106","author":"Jobling","year":"2025","journal-title":"Prog Retin Eye Res"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/978-3-030-11093-2_1","article-title":"Pericytes in the retina","volume":"1122","author":"Trost","year":"2019","journal-title":"Adv Exp Med Biol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"eaea0542","DOI":"10.1126\/sciadv.aea0542","article-title":"Functional targeting of PTTG1 in pericytes restores vascular integrity in diabetic retina","volume":"12","author":"Zhang","year":"2026","journal-title":"Sci Adv"},{"key":"B20","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1111\/1753-0407.13373","article-title":"Autophagy in the retinal neurovascular unit: new perspectives into diabetic retinopathy","volume":"15","author":"Yang","year":"2023","journal-title":"J Diabetes"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1879","DOI":"10.3390\/ijms27041879","article-title":"Role of NADPH oxidases as novel therapeutic targets for the impaired neurovascular unit in the early stage of diabetic retinopathy","volume":"27","author":"Dionysopoulou","year":"2026","journal-title":"Int J Mol Sci"},{"key":"B22","doi-asserted-by":"publisher","first-page":"110299","DOI":"10.1016\/j.exer.2025.110299","article-title":"miR-214-3p attenuates ferroptosis-induced cellular damage in a mouse model of diabetic retinopathy through the p53\/SLC7A11\/GPX4 axis","volume":"253","author":"Yuan","year":"2025","journal-title":"Exp Eye Res"},{"key":"B23","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1038\/nature25013","article-title":"Inhibition of soluble epoxide hydrolase prevents diabetic retinopathy","volume":"552","author":"Hu","year":"2017","journal-title":"Nature"},{"key":"B24","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1186\/s12974-024-03283-5","article-title":"Sitagliptin eye drops prevent the impairment of retinal neurovascular unit in the new Trpv2(+\/-) rat model","volume":"21","author":"Ramos","year":"2024","journal-title":"J Neuroinflammation"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e00438","DOI":"10.1002\/advs.202500438","article-title":"Single-cell RNA sequencing of retina reveals Nna1 upregulation in myopic diabetic retinopathy as a protective factor against diabetic damage","volume":"13","author":"Xie","year":"2026","journal-title":"Adv Sci (Weinh)"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.1038\/s41467-024-45456-z","article-title":"Modeling early pathophysiological phenotypes of diabetic retinopathy in a human inner blood-retinal barrier-on-a-chip","volume":"15","author":"Maurissen","year":"2024","journal-title":"Nat Commun"},{"key":"B27","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1167\/iovs.65.3.16","article-title":"Tandem mass tag LC-MS\/MS of aqueous humor from individuals with type 2 diabetes without retinopathy reveals early dysregulation of synaptic proteins","volume":"65","author":"Sachdeva","year":"2024","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"B28","doi-asserted-by":"publisher","first-page":"104867","DOI":"10.1016\/j.mvr.2025.104867","article-title":"Retinal neurodegeneration and choroidal changes of early diabetes in peripapillary region detected by swept-source optical coherence tomography angiography","volume":"163","author":"Zheng","year":"2026","journal-title":"Microvasc Res"},{"key":"B29","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1007\/s10633-019-09718-2","article-title":"Electrophysiological measures of dysfunction in early-stage diabetic retinopathy: no correlation between cone phototransduction and oscillatory potential abnormalities","volume":"140","author":"McAnany","year":"2020","journal-title":"Doc Ophthalmol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"e002938","DOI":"10.1136\/bmjdrc-2022-002938","article-title":"Early choroidal changes detected by swept-source OCT in type 2 diabetes and their association with diabetic kidney disease","volume":"10","author":"Da Silva","year":"2022","journal-title":"BMJ Open Diabetes Res Care"},{"key":"B31","doi-asserted-by":"publisher","first-page":"e539","DOI":"10.1111\/aos.15787","article-title":"Retinal neurodegeneration in eyes with NPDR risk phenotypes: a two-year longitudinal study","volume":"102","author":"Reste-Ferreira","year":"2024","journal-title":"Acta Ophthalmol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.1007\/s00592-024-02308-y","article-title":"Peripapillary microvasculature and retinal nerve fiber layer damage according to the severity of diabetic retinopathy","volume":"61","author":"Lee","year":"2024","journal-title":"Acta Diabetol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"110729","DOI":"10.1016\/j.exer.2025.110729","article-title":"Homocysteine and diabetic retinopathy","volume":"262","author":"Lei","year":"2026","journal-title":"Exp Eye Res"},{"key":"B34","doi-asserted-by":"publisher","first-page":"111122","DOI":"10.1016\/j.exer.2026.111122","article-title":"Epigenetic encoding of metabolic memory in diabetic retinopathy: from molecular imprinting to neurovascular network reprogramming","volume":"270","author":"Weng","year":"2026","journal-title":"Exp Eye Res"},{"key":"B35","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s40662-023-00362-1","article-title":"Homocysteine and mitochondrial quality control in diabetic retinopathy","volume":"11","author":"Malaviya","year":"2024","journal-title":"Eye Vis (Lond)"},{"key":"B36","doi-asserted-by":"publisher","first-page":"50","DOI":"10.2337\/dc07-0632","article-title":"Homocysteine and diabetic retinopathy","volume":"31","author":"Brazionis","year":"2008","journal-title":"Diabetes Care"},{"key":"B37","doi-asserted-by":"publisher","first-page":"150272","DOI":"10.1016\/j.ijbiomac.2026.150272","article-title":"Oxidative stress in diabetic retinopathy: metabolic triggers, molecular pathways and emerging antioxidant therapies","volume":"344","author":"Che","year":"2026","journal-title":"Int J Biol Macromol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.freeradbiomed.2025.03.042","article-title":"STING immune activation of microglia aggravating neurovascular unit damage in diabetic retinopathy","volume":"233","author":"Li","year":"2025","journal-title":"Free Radic Biol Med"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.1007\/s00125-025-06628-8","article-title":"Aberrant STING signalling promotes endothelial dysfunction and neurovascular injury in diabetic retinopathy","volume":"69","author":"Qin","year":"2026","journal-title":"Diabetologia"},{"key":"B40","doi-asserted-by":"publisher","first-page":"110236","DOI":"10.1016\/j.exer.2025.110236","article-title":"miRNAs, piRNAs, and lncRNAs: a triad of non-coding RNAs regulating the neurovascular unit in diabetic retinopathy and their therapeutic potentials","volume":"251","author":"Karpagavalli","year":"2025","journal-title":"Exp Eye Res"},{"key":"B41","doi-asserted-by":"publisher","first-page":"1412138","DOI":"10.3389\/fendo.2024.1412138","article-title":"Role of microRNA in linking diabetic retinal neurodegeneration and vascular degeneration","volume":"15","author":"Zhao","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B42","doi-asserted-by":"publisher","first-page":"e2411042","DOI":"10.1002\/advs.202411042","article-title":"Targeting tRNA-derived non-coding RNA alleviates diabetes-induced visual impairment through protecting retinal neurovascular unit","volume":"12","author":"Yao","year":"2025","journal-title":"Adv Sci (Weinh)"},{"key":"B43","doi-asserted-by":"publisher","first-page":"e2426241122","DOI":"10.1073\/pnas.2426241122","article-title":"Transpupillary in vivo two-photon imaging reveals enhanced surveillance of retinal microglia in diabetic mice","volume":"122","author":"Sotani","year":"2025","journal-title":"Proc Natl Acad Sci USA"},{"key":"B44","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s12886-025-04564-0","article-title":"Functional and structural biomarkers linked to diabetic retinal neurodegeneration in pre-clinical and early diabetic retinopathy","volume":"26","author":"Ku","year":"2025","journal-title":"BMC Ophthalmol"},{"key":"B45","doi-asserted-by":"publisher","first-page":"2137","DOI":"10.1038\/s41598-025-31862-w","article-title":"Integrative severity scale for diabetic macular atrophy and ischemia using structural OCT and OCT angiography","volume":"16","author":"Yoshida","year":"2026","journal-title":"Sci Rep"},{"key":"B46","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1159\/000545097","article-title":"Correlation between systemic inflammation and morphological changes of retinal neurovascular unit in patients with early signs of diabetic retinopathy: an OCT and OCT-angiography study","volume":"68","author":"Guo","year":"2025","journal-title":"Ophthalmic Res"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1438739","DOI":"10.3389\/fendo.2025.1438739","article-title":"Recent advances and applications of optical coherence tomography angiography in diabetic retinopathy","volume":"16","author":"Zhang","year":"2025","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B48","doi-asserted-by":"publisher","first-page":"1566047","DOI":"10.3389\/fmed.2025.1566047","article-title":"Systemic inflammatory markers and neurovascular changes in the retina and choroid of diabetic patients without retinopathy: insights from wide-field SS-OCTA","volume":"12","author":"Wu","year":"2025","journal-title":"Front Med (Lausanne)"},{"key":"B49","author":"Liu","year":"2025"},{"key":"B50","doi-asserted-by":"publisher","first-page":"104716","DOI":"10.1016\/j.pdpdt.2025.104716","article-title":"Early peripapillary neurovascular injury and its relevant systemic factors in type 2 diabetic patients without retinopathy: an OCTA-based study","volume":"54","author":"Jin","year":"2025","journal-title":"Photodiagnosis Photodyn Ther"},{"key":"B51","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1186\/s12886-025-04473-2","article-title":"Automated FAZ segmentation and diabetic retinopathy classification using OCTA images","volume":"25","author":"Saeidian","year":"2025","journal-title":"BMC Ophthalmol"},{"key":"B52","doi-asserted-by":"publisher","first-page":"30225","DOI":"10.1038\/s41598-025-15712-3","article-title":"Deep learning for retinal non-perfusion and foveal avascular zone analysis in wide-field OCTA in diabetic retinopathy","volume":"15","author":"Le Boite","year":"2025","journal-title":"Sci Rep"},{"key":"B53","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1167\/iovs.65.14.20","article-title":"Retinal neurovascular impairment in full-course diabetic retinopathy: the guangdong diabetic retinopathy multiple-omics study","volume":"65","author":"Lai","year":"2024","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"B54","doi-asserted-by":"publisher","first-page":"2163","DOI":"10.1097\/IAE.0000000000000765","article-title":"Image artifacts in optical coherence tomography angiography","volume":"35","author":"Spaide","year":"2015","journal-title":"Retina"},{"key":"B55","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1167\/tvst.9.7.10","article-title":"Optical coherence tomography angiography projection artifact removal: impact on capillary density and interaction with diabetic retinopathy severity","volume":"9","author":"Ashraf","year":"2020","journal-title":"Transl Vis Sci Technol"},{"key":"B56","doi-asserted-by":"publisher","first-page":"1687","DOI":"10.1007\/s00417-020-04716-6","article-title":"Repeatability and reproducibility of vessel density measurements on optical coherence tomography angiography in diabetic retinopathy","volume":"258","author":"Levine","year":"2020","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"B57","doi-asserted-by":"publisher","first-page":"1416668","DOI":"10.3389\/fendo.2024.1416668","article-title":"Cell and molecular targeted therapies for diabetic retinopathy","volume":"15","author":"Reddy","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B58","doi-asserted-by":"publisher","first-page":"1904","DOI":"10.1016\/j.ophtha.2014.04.024","article-title":"Three-year, randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with diabetic macular edema","volume":"121","author":"Boyer","year":"2014","journal-title":"Ophthalmology"},{"key":"B59","doi-asserted-by":"publisher","first-page":"117623","DOI":"10.1016\/j.bcp.2025.117623","article-title":"Targeting ER stress of GLP-1 receptor agonist in diabetic retinopathy","volume":"245","author":"Huang","year":"2026","journal-title":"Biochem Pharmacol"},{"key":"B60","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1167\/iovs.66.9.10","article-title":"Diabetes-induced dysregulation of peripapillary and macular neurovascular units","volume":"66","author":"Mitamura","year":"2025","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"B61","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1016\/j.jcyt.2024.02.020","article-title":"Clinical-grade human embryonic stem cell-derived mesenchymal stromal cells ameliorate diabetic retinopathy in db\/db mice","volume":"26","author":"Rong","year":"2024","journal-title":"Cytotherapy"},{"key":"B62","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s12974-023-02983-8","article-title":"Fractalkine isoforms differentially regulate microglia-mediated inflammation and enhance visual function in the diabetic retina","volume":"21","author":"Rodriguez","year":"2024","journal-title":"J Neuroinflammation"},{"key":"B63","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1136\/bmj.321.7258.405","article-title":"Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study","volume":"321","author":"Stratton","year":"2000","journal-title":"Br Med J"},{"key":"B64","doi-asserted-by":"publisher","first-page":"800","DOI":"10.4103\/NRR.NRR-D-24-00001","article-title":"Topical administration of GLP-1 eyedrops improves retinal ganglion cell function by facilitating presynaptic GABA release in early experimental diabetes","volume":"21","author":"Shao","year":"2026","journal-title":"Neural Regen Res"},{"key":"B65","doi-asserted-by":"publisher","first-page":"1834","DOI":"10.1056\/NEJMoa1607141","article-title":"Semaglutide and cardiovascular outcomes in patients with type 2 diabetes","volume":"375","author":"Marso","year":"2016","journal-title":"N Engl J Med"},{"key":"B66","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1111\/dom.13172","article-title":"Semaglutide, reduction in glycated haemoglobin and the risk of diabetic retinopathy","volume":"20","author":"Vilsb\u00f8ll","year":"2018","journal-title":"Diabetes Obes Metab"},{"key":"B67","doi-asserted-by":"publisher","first-page":"2049","DOI":"10.3390\/cells13242049","article-title":"SMOX inhibition preserved visual acuity, contrast sensitivity, and retinal function and reduced neuro-glial injury in mice during prolonged diabetes","volume":"13","author":"Alfarhan","year":"2024","journal-title":"Cells"},{"key":"B68","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/s12974-024-03021-x","article-title":"The glucocorticoid receptor as a master regulator of the m\u00fcller cell response to diabetic conditions in mice","volume":"21","author":"Pfaller","year":"2024","journal-title":"J Neuroinflammation"},{"key":"B69","doi-asserted-by":"publisher","first-page":"6922946","DOI":"10.1155\/jdr\/6922946","article-title":"Targeting retinal neuroglial vascular unit damage: novel therapeutic strategies for early-stage diabetic retinopathy","volume":"2025","author":"Li","year":"2025","journal-title":"J Diabetes Res"},{"key":"B70","doi-asserted-by":"publisher","first-page":"3781","DOI":"10.1038\/s41433-023-02605-w","article-title":"Association of OCT and OCT angiography measures with the development and worsening of diabetic retinopathy in type 2 diabetes","volume":"37","author":"Srinivasan","year":"2023","journal-title":"Eye (Lond)"},{"key":"B71","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1001\/jamaophthalmol.2026.1590","article-title":"Diabetic retinal disease beginning in childhood","volume":"144","author":"Gardner","year":"2026","journal-title":"JAMA Ophthalmol"},{"key":"B72","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1167\/tvst.10.6.3","article-title":"Comprehensive proteomic profiling of aqueous humor proteins in proliferative diabetic retinopathy","volume":"10","author":"Xiao","year":"2021","journal-title":"Transl Vis Sci Technol"},{"key":"B73","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1167\/tvst.13.12.23","article-title":"Multi-omics integration with machine learning identified early diabetic retinopathy, diabetic macula edema and anti-VEGF treatment response","volume":"13","author":"Pang","year":"2024","journal-title":"Transl Vis Sci Technol"},{"key":"B74","doi-asserted-by":"publisher","first-page":"4868","DOI":"10.1016\/j.cell.2023.09.012","article-title":"Liquid-biopsy proteomics combined with AI identifies cellular drivers of eye aging and disease in vivo","volume":"186","author":"Wolf","year":"2023","journal-title":"Cell"},{"key":"B75","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.18240\/ijo.2024.07.03","article-title":"Diabetic retinopathy identification based on multi-source-free domain adaptation","volume":"17","author":"Zhang","year":"2024","journal-title":"Int J Ophthalmol"},{"key":"B76","doi-asserted-by":"publisher","first-page":"2295","DOI":"10.18240\/ijo.2024.12.19","article-title":"Artificial intelligence applications in ophthalmic optical coherence tomography: a 12-year bibliometric analysis","volume":"17","author":"Wang","year":"2024","journal-title":"Int J Ophthalmol"},{"key":"B77","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s43556-025-00297-0","article-title":"Tear lactate improves the evaluation of proliferative diabetic retinopathy in type-2 diabetes patients","volume":"6","author":"Wen","year":"2025","journal-title":"Mol Biomed"},{"key":"B78","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/bs.acc.2024.03.002","article-title":"Tear biomarkers","volume":"120","author":"Ponzini","year":"2024","journal-title":"Adv Clin Chem"},{"key":"B79","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.reth.2022.12.005","article-title":"Pluripotent stem cell-derived retinal organoid\/cells for retinal regeneration therapies: a review","volume":"22","author":"Mandai","year":"2023","journal-title":"Regen Ther"},{"key":"B80","doi-asserted-by":"publisher","first-page":"131","DOI":"10.3233\/RNN-190941","article-title":"Cell transplantation of retinal ganglion cells derived from hESCs","volume":"38","author":"Zhang","year":"2020","journal-title":"Restor Neurol Neurosci"},{"key":"B81","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.3390\/cells11132023","article-title":"GLP-1 receptor agonists in neurodegeneration: neurovascular unit in the spotlight","volume":"11","author":"Monti","year":"2022","journal-title":"Cells"},{"key":"B82","doi-asserted-by":"publisher","first-page":"439","DOI":"10.3390\/ijerph19010439","article-title":"Neurovascular impairment and therapeutic strategies in diabetic retinopathy","volume":"19","author":"Oshitari","year":"2022","journal-title":"Int J Environ Res Public Health"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1966747\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:53:40Z","timestamp":1790592820000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1966747\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":82,"alternative-id":["10.3389\/fmed.2026.1966747"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1966747","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]},"article-number":"1966747"}}