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ophthalmology neonatology paediatrics

Retinopathy of Prematurity — International Classification (ICROP3)

International Classification of Retinopathy of Prematurity 3rd revision (Chiang 2021). Combines Zone (I most posterior, III peripheral nasal), Stage (1–5), and Plus disease. Used to time treatment in screened preterm neonates.

Score interpretation

No ROP / immature retina 0

→ Continue UK ROP screening protocol per RCPCH/BAPM/RCOphth: weekly–fortnightly fundus exams until vascularisation reaches Zone III or 36 weeks PMA / discharge — whichever later.

Type 2 / mild ROP 1

→ Weekly screening. Treatment not yet indicated. Anticipate spontaneous regression but be ready to escalate.

Type 1 ROP / A-ROP — Treatment-warranted 2–3

→ Treatment within 48–72 hours: laser photocoagulation (gold standard) or intravitreal anti-VEGF (ranibizumab/bevacizumab — NICE TA855 ranibizumab). Joint neonatology + ophthalmology decision. Long-term follow-up for myopia and late detachment.

Stage 4–5 — Retinal detachment 4–5

→ Urgent paediatric vitreoretinal referral. Lens-sparing vitrectomy ± scleral buckle (Stage 4A/4B) or vitrectomy with capsulectomy (Stage 5) — outcomes guarded for Stage 5. Lifelong follow-up; visual rehabilitation; family support.

Interpretation bands for the ROP. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.