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Subspecialties Retina

Early Learning

When babies are born pre-term, the final stages of retinal development can be disrupted by the intensive oxygen therapy administered to compensate for underdeveloped lungs, leading to retinopathy of prematurity (ROP) in some cases – and potentially blindness. It’s why many researchers are on a quest to determine how best to support the ongoing retinal development and avoid disease.

Knowing that long-chain polyunsaturated fatty acids (LC-PUFAs) drive brain and retinal development in the third trimester, a Swedish team from the Sahlgrenska Academy, University of Gothenburg, decided to investigate the association between circulating LC-PUFAs and ROP in extremely pre-term infants. In their study (a secondary analysis of the randomized Donna-Mega trial comparing fish and olive oil-based supplements on ROP and other morbidities, 1), the group analyzed serum lipid levels in cord and venous blood samples obtained from 78 infants born before 28 weeks gestational age (2).

And there was a clear finding: low levels of arachidonic acid were strongly associated with ROP. In the first month of life, levels of arachidonic acid (an omega-6 fatty acid) were significantly lower in infants who then had a later diagnosis of ROP compared with those who had no ROP (p<0.05); at 32 weeks post-menstrual age, the fatty acid was significantly lower in infants who developed later severe ROP (p<0.001). Through logistic modeling, the team also identified that low arachidonic acid levels, as well as low gestational age at birth, had greater than 90 percent sensitivity for identifying ROP development.

The group hypothesize that arachidonic acid supplementation could protect against ROP development, and plan to investigate the potential in an upcoming study. The team also suggest that low levels of the fatty acid could serve as a biomarker for risk. Commenting on their findings, Chatarina Löfqvist, lead author of the study, said (3): “We believe and hope that providing children with arachidonic acid will raise the levels and reduce the amount of ROP to minimize the risk of children becoming blind.”

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  1. ClinicalTrials.gov. “A fatty acids study in preventing retinopathy of prematurity: NCT02760472”. Available at: bit.ly/DonnaMega. Accessed February 15, 2018.
  2. CA Löfqvist et al., “Association of retinopathy of prematurity with low levels of arachidonic acid”, JAMA Ophthalmol, [Epub ahead of print], (2018). PMID: 29423508.
  3. Margareta Gustafsson Kubista. “New discovery offers hope of protecting premature babies from blindness”. Available at: bit.ly/ROPDiscovery. Accessed: February 15, 2018.
About the Author
Ruth Steer
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