BLUE LIGHT-INDUCED RETINAL DAMAGE: MECHANISMS AND PROSPECTS FOR PHARMACOLOGICAL PROTECTION

Abstract

Over the past two decades, LED lighting and digital screens have significantly increased population exposure to blue light (400-500 nm). High-energy blue photons penetrate the retina and cause photochemical damage associated with age-related macular degeneration and other retinopathies. Current physical protection methods (blue-blocking glasses, yellow intraocular lenses, and software screen filters) lack robust clinical evidence and do not fully solve the problem. Pharmacological prevention using eye drops that increase retinal resistance to light stress remains largely unexplored. This review summarizes molecular mechanisms of blue light-induced retinal damage, evaluates limitations of existing physical protection, and analyzes promising pharmacological candidates for preventive eye drops. Oxidative stress is the central mechanism, triggering mitochondrial dysfunction, endoplasmic reticulum stress, NLRP3 inflammasome activation, ferroptosis, and impaired phagocytosis aggravated by A2E accumulation. In preclinical studies, natural antioxidants such as melatonin, resveratrol, anthocyanins, quercetin, and chlorogenic acid reduce reactive oxygen species, suppress apoptosis, decrease inflammation, and promote A2E degradation. However, their use as eye drops is limited by low solubility, instability, poor corneal penetration, and most importantly, the absence of clinical trials in humans. Priority areas include developing effective retinal drug delivery systems, standardizing experimental models, and conducting randomized controlled trials in high-risk groups: welders, mountaineers, heavy digital device users, and patients after intraocular lens implantation.