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Year : 2015  |  Volume : 4  |  Issue : 4  |  Page : 237-243

Zone I and posterior zone II retinopathy of prematurity

Department of Surgery, Division of Ophthalmology, McMaster University, Hamilton, Ontario L8N 3Z5, Canada

Correspondence Address:
Gloria Isaza
McMaster University Medical Centre, 3V2 Clinic, 1200 Main Street West, Hamilton, Ontario L8N 3Z5
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2249-4847.161700

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Background: There is a paucity of literature describing the stages in zone I and posterior zone II retinopathy of prematurity (ROP). Aims: The aim was to describe and compare the clinical presentation and progression to the treatment of infants with zone I and posterior zone II ROP. Settings and Design: Retrospective case series at a single tertiary care Neonatal Intensive Care Unit. Subjects and Methods: Patient information collected included: Gestational age, birth, weight, postmenstrual age (PMA) at first ROP diagnosis, and PMA at treatment. Digital retinal photographs were also analyzed when available. Statistical Analysis Used: Student's t-test, Chi-square analysis. Results: Totally, 14 of 47 (29.8%) infants were classified with zone I ROP and 33 (70.2%) as posterior zone II ROP. The mean PMA at first ROP diagnosis was 33 weeks in both zones. The incidence of treatment was higher in the zone I ROP (85.7%) compared to posterior zone II ROP (48.6%). About 50% of infants with zone I ROP had an elapsed time of 1 week from first presentation to a disease requiring treatment, compared with 6.25% of posterior zone II ROP infants. By 2 weeks, the proportion of posterior zone II infants requiring treatment rose to 56%. Sequential and nonsequential analysis of retinal images illustrated the similar atypical presentation of ROP in both zones. Conclusion: The presentation of infants with ROP in the zone I and posterior zone II are very similar. The clinical course in the zone I ROP is faster and more aggressive than posterior zone II. Due to their atypical morphology and rapid progression, appropriate recognition, and classification of ROP is needed for adequate and timely treatment.

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