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The neurovascular unit uncoupling initiates glial activation, neuronal apoptosis, blood-retinal barrier leakage, and ischemia, shifting the understanding of DR from a solely vascular disorder to a neurovascular one where early NVU impairment predicts functional deficits like reduced contrast sensitivity and progression to vision-threatening complications ( 2.2 Inflammatory pathways Inflammation is a central driver of early-stage diabetic retinopathy (DR), particularly in non-proliferative diabetic retinopathy (NPDR), where it exacerbates vascular damage and compromises the blood-retinal barrier (BRB)

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