Can Polyphenols Delay Diabetic Complications? Pterostilbene as a Translational Model in Retinal Health
At Polyphenols Applications 2026, we are pleased to welcome Dr. Ángel Luis Ortega as a speaker for a lecture exploring the growing potential of polyphenols in diabetic complications and retinal protection.
Dr. Ortega presentation, entitled: Can Polyphenols Delay Diabetic Complications? Pterostilbene as a Translational Model in Retinal Health,
will address an increasingly important question in preventive medicine:
Diabetic retinopathy (DR) is a neurovascular complication of diabetes mellitus and a leading cause of vision loss worldwide. DR is largely asymptomatic in its early stages and may be significantly advanced by the time patients become aware of visual impairment.
The most widely used classification system in clinical practice for determining the stage of DR is based on the results of the multicenter Early Treatment Diabetic Retinopathy Study (ETDRS). According to this classification, DR is divided into non-proliferative diabetic retinopathy (NPDR) in the early stages and proliferative diabetic retinopathy (PDR), based on visible ophthalmological abnormalities and the formation of abnormal retinal neovessels. Macular involvement is referred to as diabetic macular edema (DME) and represents the leading cause of vision loss in patients with diabetes. Although DME may occur at any stage of the disease, it is more common during its advanced phases.
DR has a complex etiology, however, it is well established that chronic exposure to hyperglycemia disrupts redox homeostasis, triggering early retinal neuronal cell death and pericyte loss, followed by breakdown of the blood-retinal barrier, increased vascular permeability, and progression to advanced stages characterized by pathological neovascularization.
Currently, treatment options for DR are largely restricted to advanced stages, when irreversible retinal damage has already occurred. Standard treatments for severe NPDR and PDR include argon laser photocoagulation and intravitreal administration of anti-VEGF therapies, with or without focal laser treatment for DME. Although these interventions can delay the progression to blindness, they have important limitations, including patient discomfort, potential long-term adverse effects, high economic costs, and variable therapeutic efficacy depending on the treatment regimen. Therefore, the identification of new therapeutic targets and the development of novel treatments are essential to prevent or delay DR progression.
Recently, our group demonstrated the importance of controlling oxidative stress to prevent disease progression from the early stages of DR to the development of PDR. Treatment with pterostilbene (Pter), a natural polyphenolic analog of resveratrol, in an experimental animal model restored redox balance and normalized the activity of key antioxidant enzymes, including catalase, superoxide dismutase, and glutathione peroxidase, which are dysregulated by hyperglycemia. In addition, Pter treatment prevented the early retinal lipid peroxidation induced by diabetes, a process that plays a critical role in the onset and progression of DR. Furthermore, in a pilot clinical trial, oral administration of Pter delayed the development of retinal vascular abnormalities and restored redox homeostasis in patients with diabetes. Notably, retinal vascular alterations appeared after discontinuation of the polyphenol treatment for six months.
Taken together, our findings suggest that Pter may help delay the progression of DR by protecting against oxidative stress and highlight the importance of early antioxidant intervention to prevent disease progression.
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