Retinopathy of Prematurity: Protecting Your Preemie’s Vision

Retinopathy of Prematurity (ROP) is an eye condition that affects premature babies, especially those who are born before 30 weeks or whose birth weight was less than 3 pounds. ROP occurs when the blood vessels in the retina (the part of the eye that senses light) don’t develop properly. While mild cases can improve on their own, more serious cases may lead to vision problems or even blindness if not treated. There are no early signs of ROP that parents can see at home, and since it can worsen quickly, regular eye exams are essential for early detection.

What causes ROP?

A baby’s retina’s blood vessels usually develop fully by the time of the baby’s birth. If the baby is born too early this process is interrupted and abnormal blood vessels may grow. These abnormal blood vessels can pull on the retina, leading in some cases to detachment.

Factors that can increase the risk of ROP:

Premature Birth (before 30 weeks)
Low Birth Weight (under 3 pounds)
Breathing problems or use of oxygen therapy
Infections or complications affecting the heart, lungs, or brain

While oxygen levels and genetic factors play a role, new research shows the importance of nutrition, specifically the balance between omega-3 and omega-6 fatty acids in protecting against ROP.

The Role of Omega-3 and Omega-6 Fatty Acids:

Omega-3 and omega-6 fatty acids are essential for development. Premature babies often lack these nutrients as they miss the third trimester, a period when these fatty acids are transferred from mother to fetus.

Omega-3 Fatty Acids (DHA and EPA): These fatty acids, found in fish like salmon, mackerel, and tuna, as well as in krill or algae oil, promote healthy blood vessel growth and reduce inflammation.
Omega-6 Fatty Acids (AA): Found in foods like eggs, chicken, and beef, omega-6 fatty acids support neuronal growth and metabolism.

A study by Fu et al. (2022) shows that the balance between these two is key, and an imbalance can lead to incomplete retinal development and long-term visual impairments.

For breastfeeding mothers, consuming omega-3-rich foods like fatty fish, flaxseed, and walnuts can enhance the quality of their milk, ensuring their preterm infants receive these essential nutrients.

For infants, opting for formulas or breast milk enriched with DHA and EPA can offer comparable benefits, and Preemie Sensor can assist in ensuring proper fortification, as it measures important fatty acids. To dive deeper into the specific fatty acids and their importance in retinal development, check out our other blog on “Omega-3 Fatty Acids & Premature Babies: Vital Nutrients for Early Development”.

Stages of ROP and Treatment Options

If your baby is at risk for ROP, an eye specialist should examine their eyes 4-9 weeks after birth. Medical professionals will use eye drops in order to widen the pupil and check for signs of abnormal blood vessel growth. ROP can be classified into 5 stages:

Stages 1 and 2:
- These are mild cases that usually improve without treatment.
- These still will need to be monitored closely by your healthcare provider.
Stage 3: Some babies recover without treatment, but others may need medical intervention to prevent abnormal blood vessels from causing retinal detachment.
Stage 4: The retina is partially detached and requires treatment.
Stage 5: The retina is fully detached, even with surgery babies in stage 5 will likely have vision loss or blindness.

Retinopathy of Prematurity is a significant concern for premature infants, but early detection and proper nutrition can make a difference. Omega-3 fatty acids, particularly DHA and EPA, play a vital role in supporting retinal and neurological development, reducing inflammation, and promoting healthy blood vessel growth. Parents of premature infants should work closely with healthcare professionals to develop a nutrition plan that meets their baby’s specific needs (during pregnancy and post-partum).

REFERENCES

National Eye Institute. (2024, November 27). Retinopathy of prematurity. U.S. Department of Health & Human Services. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinopathy-prematurity
Fu, Z., Yan, W., Chen, C. T., Nilsson, A. K., Bull, E., Allen, W., Yang, J., Ko, M., SanGiovanni, J. P., Akula, J. D., Talukdar, S., Hellström, A., & Smith, L. E. H. (2022). Omega-3/Omega-6 Long-Chain Fatty Acid Imbalance in Phase I Retinopathy of Prematurity. Nutrients, 14(7), 1333. https://doi.org/10.3390/nu14071333