Br J Ophthalmol 96:519-522 doi:10.1136/bjophthalmol-2011-300321
  • Clinical science
  • Original article

A hybrid form of retinopathy of prematurity

  1. Amod Gupta
  1. Department of Ophthalmology, Advanced Eye Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Professor Dr Mangat R Dogra, Advanced Eye Center, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India; drmangatdogra{at}
  1. Contributors Mangat R Dogra, Gaurav Sanghi and Amod Gupta conceptualised and designed the study. Gaurav Sanghi, Mohit Dogra and Deeksha Katoch were involved in data collection, analysis and interpretation of data and drafting the article. Mangat R Dogra and Amod Gupta were involved in critical revision of manuscript. All authors approved the final version of manuscript. Mangat R Dogra is guarantor of the study.

  • Accepted 24 September 2011
  • Published Online First 17 November 2011


Aims To study a hybrid pattern of retinopathy of prematurity (ROP) demonstrating both ridge tissue (simulating staged ROP) and flat neovascularisation (simulating aggressive posterior retinopathy of prematurity (APROP)) in the same eye.

Methods Retrospective chart review from January 2006 to June 2010. We reviewed the retinal drawings and Retcam images for a hybrid pattern of ROP, that is, presence of ridge tissue (characteristic of staged ROP) along with flat neovascular syncytium (characteristic of APROP) in the same eye.

Results 28 eyes of 18 infants had hybrid characteristics. All eyes had severe plus disease, flat new vessels at the junction of the vascular and avascular retina and ridge tissue at variable locations. Three patterns were noted: I Ridge at the junction of vascular and avascular retina (14 (50%) eyes); II Ridge in the vascularised posterior retina (10 (35.71%) eyes); III Ill-defined ridge close to the optic disc, with mat-like fibrous proliferation into the vitreous (4 (14.29%) eyes). After confluent laser photocoagulation, we observed favourable outcome in 92.3% eyes with pattern I, 100% eyes with pattern II and 25% eyes with pattern III disease.

Conclusion Some eyes with ROP may have abnormal neovascularisation resembling both APROP and classical staged ROP. It is difficult to characterise these eyes according to the international classification of ROP. However, the presence of plus disease should serve as guide to treatment.


  • Competing interests None.

  • Ethics approval Ethics approval was provided by Postgraduate Institute of Medical Education and Research, Chandigarh, India.

  • Provenance and peer review Not commissioned; externally peer reviewed.