Sequelae of retinopathy of prematurity

Retinopathy of prematurity (ROP) affects preterm infants. Here we describe its revised classification and the amended treatment indications which recommend treatment at an earlier ROP stage known as ‘prethreshold’. The three global ROP epidemics are briefly discussed. ROP sequelae are discussed under four headings: visual functions, strabismus, refractive state and the effect of ROP on the structures of the eye. While ROP is potentially blinding, in general, ophthalmic outcome is similar for preterm children who did not develop ROP or in whom this was only mild (stages 1 & 2). In the main their deficits are not functionally disabling, although treatment, to correct a refractive error, strabismus or amblyopia, may be required. The outcome for children who had severe, potentially sight-threatening ROP (stages 3–5 and prethreshold) is far more variable and in a proportion of children is disabling and even blinding. Whether children who had ROP need follow-up is discussed. Finally the future role of anti-VEGF treatment is considered.