Retinopathy of Prematurity Classification

Retinopathy of Prematurity

Zone 1	Circle centered on nerve with radius twice the distance from nerve to fovea
Zone 2	Circle extending to ora serrata nasally
Zone 3	Temporal crescent extending to ora serrata temporally

Stage

Stage 0	Immature vascularization, no ROP
Stage 1	Demarcation line
Stage 2	Ridge
Stage 3	Extraretinal fibrovascular proliferation
Stage 4	Partial retinal detachment Stage 4A – extrafoveal Stage 4B – foveal
Stage 5	Total retinal detachment Funnel: Anterior or posterior, open or closed

Plus Disease

Plus disease	– At least 2 quadrants of venous dilation and tortuosity – Vitreous haze – Failure of pupil to dilate – Preretinal or vitreous hemorrhage
Pre-plus disease	Abnormal dilation and tortuosity not sufficient to meet plus criteria
Threshold disease	5 contiguous or 8 non-contiguous clock hours of extraretinal neovascularization in zone 1 or zone 2 with plus disease
Aggressive posterior ROP (rush disease)	Posterior location, prominence of plus disease, ill-defined nature of retinopathy

ETROP Classification

Type 1 ROP	Zone I, any stage with plus disease Zone I, stage 3 without plus disease Zone II, stage 2 or 3 with plus disease
Type 2 ROP	Zone I, stage 1 or 2 without plus disease Zone II, stage 3 without plus disease

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