Diabetic Retinopathy, Beyond VEGF, A Neurovascular Disease

Diabetic retinopathy has long been treated as a disease of leaky, fragile blood vessels, with anti-VEGF injections as a cornerstone of care. But a growing body of research suggests the story starts earlier — in the retina's neurons and glia — well before the classic vascular signs appear. In this episode, Dr. Saikumar Gandapodi joins us to unpack what it means to view diabetic retinopathy as a neurovascular disease.We explore the unit that links neurons, glia, and vessels, why anti-VEGF therapy is powerful yet incomplete, and where mechanisms like oxidative stress, chronic inflammation, and neurotrophin decline may fit. Dr. Gandapodi explains how the Netra Restoration Therapy framework approaches the eye as part of a whole metabolic system — always as a complement to, never a replacement for, standard ophthalmic care.Throughout, we stay honest about the evidence: separating what's established from what's still emerging, distinguishing lab and animal work from human trials, and focusing on what patients living with diabetes can actually take away today.