Published Paper Details:

Diabetic retinopathy (DR) represents a major microvascular complication of diabetes mellitus and remains the leading cause of preventable blindness in working-aged adults worldwide. With the global burden of diabetes escalating, the prevalence of DR is projected to increase from 103.12 million affected individuals in 2020 to 160.5 million by 2045. The pathophysiology of DR involves complex, interconnected biochemical pathways including polyol pathway activation, advanced glycation end-product formation, protein kinase C dysregulation, and oxidative stress, all of which culminate in retinal vascular dysfunction, inflammation, and neurodegeneration. Traditionally managed through laser photocoagulation and vitrectomy, DR treatment has been revolutionized by anti-vascular endothelial growth factor therapies. Recent advances have introduced novel therapeutic modalities including next-generation bispecific antibodies such as faricimab, gene therapy approaches targeting mechanistic pathways, stem cell-based regenerative treatments, and systemic agents like sodium-glucose cotransporter-2 inhibitors. This comprehensive review examines the molecular mechanisms underlying DR pathogenesis, discusses established treatment paradigms, and explores emerging therapeutic strategies that promise to transform disease management and improve visual outcomes for millions of patients globally.