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Fig. 5.2 a-f. Stages 1-3 of acute ROP as seen by indirect ophthalmoscopy (a-c) and with digital wide field imaging (d-f)

Table 5.3. RM-ROP2

Fig.5.3a-c. Zone I disease in a ELBW premature (GA 25 weeks, BW 710 g). a First examination at post-menstrual age PMA 31 weeks/postnatal age 6 weeks. Extremely thin retinal vessels ending in zone I. Arrows highlight the extremely thin arteries visible only in zone I. b Two weeks later (PMA 33 weeks), compared to 1st exam now dilated retinal vessels with intraretinal proliferations in zone I. Treatment (at prethreshold) scheduled within 72 h. c At the time of treatment further rapid progression with widespread intraretinal hemorrhages.This is an example of a very aggressive form of zone I disease

Fig.5.3a-c. Zone I disease in a ELBW premature (GA 25 weeks, BW 710 g). a First examination at post-menstrual age PMA 31 weeks/postnatal age 6 weeks. Extremely thin retinal vessels ending in zone I. Arrows highlight the extremely thin arteries visible only in zone I. b Two weeks later (PMA 33 weeks), compared to 1st exam now dilated retinal vessels with intraretinal proliferations in zone I. Treatment (at prethreshold) scheduled within 72 h. c At the time of treatment further rapid progression with widespread intraretinal hemorrhages.This is an example of a very aggressive form of zone I disease

Table 5.2. Definition of threshold disease and of prethreshold disease [9]

Threshold disease

Stage 3+ in zone I and IIa 5 or more contiguous clock hours 8 or more cumulative clock hours Plus disease: dilation and tortuosity of posterior pole retinal vessels in at least two quadrants meeting or exceeding that of a standard photograph.

Prethreshold disease Zone I

Any disease below threshold Zone II Stage 2 with plus disease Stage 3 without plus disease Stage 3 with plus disease but below threshold Plus disease: dilation and tortuosity of posterior pole retinal vessels in at least two quadrants meeting or exceeding that of a standard photograph a In zone I and posterior zone II disease, vascular proliferation may be intraretinal only or very flat on the retinal surface (Fig. 5.3). There is a high risk of progression to retinal detachment without appearance of extraretinal proliferation. This fact has been accounted for in more recent national guidelines [8]

Table 5.3. RM-ROP2

p = {1 + exp[- (a + p^! + p2x2 + bkxk)]}-1 Each X; is an infant that increased (or decreased) the risk p to have an unfavorable outcome. The and a are coefficients in the risk model that are estimated from these data. The bj is the coefficient associated with x; and a is a constant term. The function exp raises the expression in brackets to the base e = 2.71828...

Table 5.4. Early treatment for retinopathy of prematurity ETROP. Classification of treatment-requiring ROP

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