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Retinal development in very-low-birth-weight infants fed diets differing in omega-3 fatty acids
D G Birch1, E E Birch, D R Hoffman
1Anderson Vision Research Center, Retina Foundation of the Southwest, Dallas, Texas 75231.
Insights
Omega-3 fatty acids are crucial for retinal development in very-low-birth-weight infants. Insufficient omega-3 intake negatively impacts rod function, highlighting the importance of dietary fatty acids for infant eye health.
Area of Science:
- Neonatal nutrition
- Ophthalmology
- Developmental biology
Background:
- Normal retinal development is critical for visual function.
- Very-low-birth-weight (VLBW) infants have unique nutritional needs.
- Essential fatty acids, particularly omega-3s, play a role in visual system development.
Purpose of the Study:
- To investigate the essentiality of omega-3 fatty acids for normal human retinal development in VLBW neonates.
- To compare retinal function in VLBW infants fed different infant formulas versus human milk.
- To assess the impact of dietary fatty acid composition on electroretinogram (ERG) parameters.
Main Methods:
- Full-field electroretinograms (ERGs) were recorded from VLBW infants (n=81) fed different formulas or human milk.
- Infant formulas varied in omega-3 content: Formula A (low omega-3), Formula B (alpha-linolenic acid only), Formula C (alpha-linolenic acid and marine oils).
- ERG assessments were conducted at 36 and 57 weeks postconception.
Main Results:
- Significant differences in rod electroretinogram (ERG) function were observed among the groups.
- Infants fed Formula A (low omega-3) exhibited significantly higher rod thresholds compared to those receiving long-chain omega-3.
- Differences in b-wave origin at the photoreceptor level were noted, with delayed implicit times in oscillatory potentials for Formula A at 57 weeks.
Conclusions:
- Dietary omega-3 fatty acids are essential for normal retinal function in VLBW infants.
- The supply of omega-3 fatty acids significantly influences rod photoreceptor function.
- These findings underscore the importance of adequate omega-3 supplementation for visual development in preterm infants.
Abstract:
Full-field electroretinograms (ERGs) were obtained from very-low-birth-weight (VLBW) neonates to determine whether omega-3 (omega-3) fatty acids are essential for normal human retinal development. Eighty-one infants born at 30.4 (standard deviation, +/- 1.5) wk gestation were, within 10 d of birth, either enrolled to receive mother's milk (naturally containing both omega-6 and omega-3 essential fatty acids) or randomized to receive one of the infant formulas. Corn oil-based Formula A contained mainly linoleic acid (18:2 omega-6) and was low in all omega-3 fatty acids. Soy oil-based Formula B contained ample alpha-linolenic acid (18:3 omega-3) but no long-chain omega-3. Formula C, supplemented with both alpha-linolenic acid and marine oils, was comparable to human milk in long-chain omega-3. Full-field ERGs were obtained in the special care nursery from infants aged 36 and 57 wk postconception. Ten healthy preterm infants born at 35 wk gestation were tested at 36 wk postconception. Significant differences were found among groups in rod ERG function. Post hoc comparisons showed that infants fed Formula A had significantly higher rod thresholds than infants receiving long-chain omega-3 (human milk, Formula C, and intrauterine). Infants receiving Formula B had intermediate thresholds that were significantly higher than those of infants receiving intrauterine nutrition. Analysis of the leading edge of the a-wave showed that b-wave differences originated at the photoreceptor level. Differences were not present in infants at 57 wk postconception. No significant differences among groups were found in cone b-waves at 36 or 57 wk postconception. Oscillatory potentials had significantly longer implicit times at 57 wk postconception in infants fed Formula A than in infants receiving human milk. These findings suggest that retinal function varies with the dietary supply of omega-3 fatty acids in VLBW infants.