Potential Effects of Nutraceuticals in Retinopathy of Prematurity

Abstract

Retinopathy of prematurity (ROP), the most common cause of childhood blindness, is a hypoxia-induced eye disease characterized by retinal neovascularization. In the normal retina, a well-organized vascular network provides oxygen and nutrients as energy sources to maintain a normal visual function; however, it is disrupted when pathological angiogenesis is induced in ROP patients. Under hypoxia, inadequate oxygen and energy supply lead to oxidative stress and stimulate neovasculature formation as well as affecting the function of photoreceptors. In order to meet the metabolic needs in the developing retina, protection against abnormal vascular formation is one way to manage ROP. Although current treatments provide beneficial effects in reducing the severity of ROP, these invasive therapies may also induce life-long consequences such as systemic structural and functional complications as well as neurodevelopment disruption in the developing infants. Nutritional supplements for the newborns are a novel concept for restoring energy supply by protecting the retinal vasculature and may lead to better ROP management. Nutraceuticals are provided in a non-invasive manner without the developmental side effects associated with current treatments. These nutraceuticals have been investigated through various in vitro and in vivo methods and are indicated to protect retinal vasculature. Here, we reviewed and discussed how the use of these nutraceuticals may be beneficial in ROP prevention and management.

Plasma levels of amino acids and derivatives in retinopathy of prematurity

“…On the other hand, breast milk feeding, parenteral nutrition volume, and intake of vitamins may affect rates of ROP surgery requirement 8 . Supplements of nutrition for newborn infants are novel strategies for restoring energy supply and may be effective in protecting the vasculature of the retinas, and some nutraceuticals may aid in preventing ROP occurrence 9 . Moreover, accumulating evidence indicates that a higher intake of amino acids significantly reduces ROP but not severe ROP 4 .…”

Role of Oxidative Stress in Retinal Disease and the Early Intervention Strategies: A Review

“…Oxidative Medicine and Cellular Longevity been shown to protect against ROP because of their ability to scavenge ROS [142,143]. Additionally, supplementation with antioxidants, such as carotenoids and vitamins (A and E), helps to promote normal fetal growth, resulting in a reduction in the birth rate of preterm infants; although, there is no clinical evidence that it can prevent ROP in LBWs [144][145][146][147]. Moreover, supplementation with essential fatty acids, e.g., ω-fatty acids, leads to a decrease in ROP development, which can be explained by the antioxidant effect of unsaturated fatty acids that reduces lipid peroxidation [148,149].…”

Neurosensory Alterations in Retinopathy of Prematurity: A Window to Neurological Impairments Associated to Preterm Birth

“…In this respect, there is evidence from our group that treatments based on natural antioxidant/anti-inflammatory compounds may prevent RGC death in several models of RGC degeneration [ 131 , 132 , 133 , 134 ], suggesting that such an approach may be useful also in counteracting neurodegeneration of RGCs in ROP. The use of nutraceuticals as a non-invasive approach in preventing ROP and in its management has been recently reviewed and discussed [ 135 ].…”