Chapter 23 - Fish-Oil Fat Emulsion and Retinopathy in Very Low Birth Weight Infants

Abstract

Docosahexaenoic acid (DHA) is a major structural lipid in sensory and vascular retina. Prematurely delivered infants demonstrate a cumulative DHA deficiency that is highly correlated with the earlier gestational ages and lower birth weights. DHA deficiency is associated with structural and functional abnormalities in the visual system. Primates with experimentally induced DHA deficiency have aberrations in retinal structure, altered visual acuity, and diminished cognitive performance. Alternatively, a higher dose of DHA given as a nutritional supplement in the neonatal period improves visual acuity of preterm infants. An important body of evidence indicates that parenteral administration of fat emulsions that contain fish-oil-related lipids are safe, well tolerated, and beneficial in establishing an appropriate fatty acid profile in preterm infants. The reduced risk of developing severe retinopathy of prematurity when preterm infants are nourished with fish-oil-based emulsion as part of parenteral nutrition, from the first day of life, is promising.