Retinopathy of prematurity’s turning point
- 1Smith-Kettlewell Eye Research Institute, San Francisco, CA, USA
- 2Memorial University, Newfoundland, Canada
- Correspondence to: William V Good MD Smith Kettlewell Eye Research Institute, 2318 Fillmore Street, San Francisco, CA 94115, USA; Goodski.org
This point may be identified ophthalmoscopically as the subthreshold (prethreshold) state for some eyes
Stepp’d in so far that, should I wade no more,Returning were as tedious as go o’er.(William Shakespeare (1564–1616) Macbeth. Act iii, Sc 4)
As new and successful treatments emerge for the management of retinopathy of prematurity (ROP), it becomes increasingly apparent that considerable morbidity accompanies more advanced disease, even when the condition regresses, and with or without treatment to effect regression. ROP research perforce will be aimed at further reducing blindness from the disease, and also at eliminating these other complications.
What are these other complications? Myopia is one, but unfavourable optotype acuity, strabismus, anisometropia, amblyopia, glaucoma, and cataract can all occur in the absence of retinal detachment. The paper by Sahni and associates in this issue of the BJO (p 154) reminds us that infants with regressed, prethreshold ROP eyes have better visual acuity, refractive error outcome, and anatomical outcome than infants whose ROP progresses to require treatment. Somewhere in the disease process a point is reached, beyond which there is no turning back. The authors should be congratulated on their thought provoking effort. Since this work confirms findings in other experiments, it begs the question, what is it about more …
