Paeds Vivas · fetal-neonatal-and-perinatal
Retinopathy of prematurity
Viva scenario on a preterm infant reaching the Type 1 ROP treatment threshold.
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Prompt
A 25-week gestation infant, birth weight 640 g, is now 33 weeks postmenstrual age. Retinal examination shows Zone I stage 3 disease with prominent plus disease in both eyes.
Branch 1: Classification
Examiner: Describe this infant's ROP. Expected response: This is Type 1 ROP. Zone I is the most posterior zone, and Zone I stage 3 disease with plus disease meets Type 1 criteria, which is the treatment threshold established by the ETROP trial [1]. The classification is recorded for each eye by zone, stage, extent in clock-hours, and the presence of plus disease per ICROP-3 [3].
References4ShowHide
- [1]Early Treatment for Retinopathy of Prematurity Cooperative Group Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial Arch Ophthalmol, 2003.PMID 14662586
- [2]Mintz-Hittner HA, Kennedy KA, Chuang AZ; BEAT-ROP Cooperative Group Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity N Engl J Med, 2011.PMID 21323540
- [3]Chiang MF, Quinn GE, Fielder AR, et al International Classification of Retinopathy of Prematurity, Third Edition Ophthalmology, 2021.PMID 34247850
- [4]Fierson WM Screening Examination of Premature Infants for Retinopathy of Prematurity Pediatrics, 2018.PMID 30478242