Gene therapy for diabetic retinopathy

Figure 1 Conceptual overview of gene therapy strategies for diabetic retinopathy and diabetic macular edema. Schematic depiction of the “retinal biofactory” paradigm in which ocular gene transfer is used to enable sustained intraocular expression of therapeutic effectors - currently centered on durable anti-vascular endothelial growth factor activity to reduce treatment burden - while illustrating extension toward inflammation modulation, vascular stabilization, and neurovascular protection. The figure also emphasizes clinically relevant variables that shape translation, including delivery route (intravitreal, subretinal, or suprachoroidal) and the main constraints discussed in the manuscript, particularly route- and dose-dependent intraocular inflammation and uncertainties regarding long-term durability and the feasibility of re-dosing. VEGF: Vascular endothelial growth factor. Image(s) provided by Servier Medical Art (Available from: https://smart.servier.com), licensed under CC BY 4.0 (Available from: https://creativecommons.org/Licenses/by/4.0/).