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Emerging mechanisms: while ROS generation is well-established, recent research highlights more subtle, sub-lethal mechanisms: Autophagy modulation: ENMs like graphene oxide (GO) can induce autophagic flux blockade, where the accumulation of autophagosomes leads to cell death even in the absence of massive ROS

Gut microbiota alterations even after disease resolution and the gastrointestinal symptoms are the key features of PACS

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Systematic data describing how this feedback loop evolves across DR stages (non-proliferative versus proliferative) are also lacking, making it difficult to align potential interventions with the precise windows of the clinical disease course