Effect of supplementation with macular carotenoids on retinopathy of prematurity: A systematic review

Retinopathy of prematurity (ROP) is a prevalent and sight-threatening condition observed in premature infants, characterized by abnormal vascular development in the retina. While the etiology of ROP is multifaceted, oxidative stress within the infant eye is a common factor associated with its occurrence. Macular carotenoids, natural antioxidant pigments abundant in green leafy vegetables, have garnered interest as a potential means to mitigate ROP risk in neonates, owing to their antioxidant properties and nutritional safety. However, current research yields conflicting results regarding their effectiveness in this context. In this systematic review, we comprehensively assess the existing literature to uncover and elucidate these discrepancies. Our analysis reveals significant disparities in the conclusions drawn from clinical studies and animal models investigating the effects of macular carotenoids on ROP. Promising results were shown in the animal studies but not in clinical studies. We identify three major factors contributing to these discordant findings. First, limitations in the established animal model of ROP may introduce inaccuracies. Secondly, variations in dosage and administration protocols of macular carotenoids play a pivotal role. Lastly, temporal fluctuations in supplement formulations could also impact the observed outcomes. By shedding light on these critical disparities, our study provides valuable insights into the challenges and potential avenues for refining the utilization of macular carotenoids as a strategy for reducing ROP risk in neonates.