Black Phosphorus Quantum Dots Effectively and Safely Treat Glaucoma as a Promising Anti-Ferroptosis Nano-drug

Abstract Globally, irreversible blindness is mainly caused by glaucoma, characterized by the selective loss of retinal ganglion cells (RGCs). Reducing pathologically high intraocular pressure (ph-IOP) is clinically effective but fails to halt disease progression. Oxidative stress-induced RGC ferroptosis contributes to poor outcomes after ph-IOP reduction. Thus, drugs to alleviate oxidative stress and inhibit RGC ferroptosis have therapeutic potential for glaucoma treatment. Herein, we first attempted to apply black phosphorus quantum dots (BPQDs) ophthalmologically, primarily exploiting its reactive oxygen species (ROS) scavenging abilities and non-toxic degradation. Briefly, BPQDs were injected into the vitreous chamber of ph-IOP-injured glaucomatous rats. Injected BPQDs maintained therapeutic effectiveness for almost one week without significant cellular toxicity. Meanwhile, BPQDs demonstrated potent ROS scavenging and cellular redox repairing abilities, ultimately inhibiting RGC ferroptosis and improving both morphological and functional outcomes in glaucomatous rats. Thus, BPQDs represent the first and potential anti-ferroptosis nano-drug to treat glaucoma and other ferroptosis-related diseases.