Chronic dental lighting disrupts blood-retinal barrier homeostasis via vascular and inflammatory pathways

Excessive lighting is integral to dentists' daily routines but can impair their vision, affecting personal and professional performance. Most studies focus on acute photodamage, neglecting chronic photo-injury from dental lighting and its impact on the blood-retinal barrier homeostasis. An epidemiological survey involving 14,523 individuals showed dentists had 3.6 times higher odds of vision-related issues compared to other occupations (OR = 3.639, 95% CI: 3.064-4.323). Subsequently, chronic photodamage models in rats were created to accurately simulate dental working conditions. Using systematic imaging and gene analysis, including OCT, tissue clearing technology and RNA-sequencing, dental lighting was found to disrupted both inner and outer blood-retinal barriers, reduced retinal blood vessels, and promoted perivascular macrophage recruitment. Among them, the number of capillary branches decreased sharply. Moreover, the activation of inflammatory-related pathways such as NF-κB signaling resulted in the damage of vision-related functional structures in the retina. Notably, among three dental light sources, low-intensity halogen caused minimal retinal damage, whereas blue and white LEDs significantly disrupted blood-retinal barrier homeostasis. This study explored the potential mechanism of dental lighting environment inducing the disruption of blood-retinal barrier homeostasis, and provided essential guidance for dental professionals in selecting light sources, which is conducive to reducing the risk of occupational ocular diseases among dentists.