Threshold Retinopathy of Prematurity Revisited

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Abstract
Associated with the increase in survival of premature infants is a significant incidence of retinopathy of prematurity (ROP). Two features of ROP should be emphasized. First, it is a lifetime disease. Even infants who never require treatment during the active stages may later develop myopia, exudative or rhegmatogenous retinal detachments, cataracts, angle closure glaucoma, neovascular glaucoma, or visual loss from progressive retinal pigment epithelial changes or cystoid macular edema.1,2 Second, the sequelae of the active stages, ie, retrolental tissue, retinal detachment, and retinal fold, are better prevented than managed after they occur.3,4 Although some stage 4 retinal detachments can be reattached with scleral buckling and stage 5 retinal detachments can be reattached with vitrectomy, the functional results are disappointing.3 Undoubtedly, the study by the Cryotherapy for Retinopathy of Prematurity Cooperative Group3 was invaluable since, for the first time, a therapy for stage 3 + ROP was shown