Inadvertent Skip Areas in Treatment of Zone 1 Retinopathy of Prematurity

Abstract

Abstract: : Purpose: To present examples illustrating the unique aspects of Zone 1 disease and identifying key difficulties in the diagnosis and management of stage 3 ROP in Zone 1. Methods: Presentation of prospective data acquired from our recent experience with serial photographic documentation of Zone 1 ROP in the Photographic Screening Trial for ROP (Photo-ROP). Results: Important features of Stage 3 ROP in Zone 1 include: 1) flat, broad topography of neovascularization, 2) avascular retina underlying area of neovascularization, 3) prominent choroidal vessels underlying the attenuated retinal pigment epithelium of prematurity which may be mistaken for vascularized retina. Conclusions: Awareness of unique features of ROP when present in posterior Zone 1 is important for timely diagnosis and treatment. Treatment of the full extent of avascular retina requires accurate determination of the full extent of avascular retina, and may require extension of near-confluent laser into the area of flat neovascularization.  

Keywords: 572 retinopathy of prematurity