Decreased Levels of Erythrocyte Membrane Arachidonic and Docosahexaenoic Acids Are Associated With Retinopathy of Prematurity

PURPOSE. Retinopathy of prematurity (ROP) can lead to blindness. Arachidonic acid (ARA) and docosahexaenoic acid (DHA) regulate retinal inflammation and angiogenesis. The aim of this study was to investigate red blood cell membrane (RBCM) ARA and DHA in preterm infants. METHODS. This prospective observational study divided infants into groups by ROP severity and RBCM ARA and DHA means and terciles. RESULTS. Although the mean +/- SD RBCM ARA was different between groups (no ROP, 17.9% +/- 0.7%, vs. type 2 ROP, 17.4% +/- 0.8%, vs. type 1 ROP, 16.7% +/- 1.0%; P < 0.001), the mean RBCM DHA was similar (P = 0.161). Infants with type 1 ROP were more likely to be in the lowest ARA and DHA terciles than in the highest (ARA, 44% vs. 5.6%; DHA, 22% vs. 5.6%). ARA and DHA declined over the first month of life in all ROP groups. At week 1, ARA was lower in the type 1 and type 2 ROP groups compared with the no-ROP group (18% +/- 2% and 19% +/- 3% vs. 21% +/- 2%, respectively; P < 0.05 for all). At week 2, DHA and ARA were lower in the type I ROP group compared with the no-ROP group (3% +/- 1% vs. 4% +/- 1%, P = 0.03 and 16% +/- 1% vs. 19% +/- 1%, respectively; P < 0.01). A RBCM ARA% >= 17 was associated with a 45% reduction in any ROP. As the estimated 4-week ARA% mean increased by 1%, the odds of ROP decreased by 70% (odds ratio = 0.30; 95% confidence interval, 0.1-0.7). CONCLUSIONS. Infants with severe ROP have lower ARA and DHA levels than infants without ROP. ARA and DHA may act synergistically to protect against ROP.