Nrf2/HO-1 signaling in retinal neurodegenerative diseases: redox homeostasis, cytoprotection, and therapeutic perspectives

Retinal neurodegenerative diseases represent a group of disorders leading to irreversible vision loss. Their development involves persistent oxidative stress, mitochondrial dysfunction, inflammatory processes, lipid peroxidation, and disruption of neurovascular unit homeostasis. The Nrf2/HO-1 signaling pathway, consisting of the Nrf2 factor and its effector heme oxygenase-1, plays a key role in cellular defense against oxidative stress and adaptation to stress conditions. Preclinical research suggests that Nrf2/HO-1 signaling may protect retinal cells, regulate inflammation, and maintain neurovascular homeostasis through modulation of redox balance. Further development of this therapy will require stronger evidence of causal relationships, improved drug delivery to the eye, and better targeting of specific cell types.