Atypical ROP?

Figure: The contrast of the photograph was enhanced. The temporal vessels are straightened and there is a folding across the foveal zone. Peripherally, there is confluent laser and pink fibrovascular tissue. On indirect there was retinal elevation at the base of the fibrovascular proliferation.

Is this atypical ROP? Yes or No?

This girl was born at 37 weeks 3543 gms by c-section because of severe anemia from bleeding in utero. Was examined for ROP and treated with laser. She was referred for continued activity after complete laser treatment. I watched her for 5 weeks when she developed a 4A detachment and a macular pucker. At surgery the macula was folded by the pucker that was very adherent and after persistent meticulous effort was released and removed. The retina attached. The patient had no rash or seizures.

I performed fluorescein angiography on both parents looking for evidence of FEVR, or Norrie carrier state. Both parents were perfectly normal to the ora serrata.

The macular pucker is my second case in "ROP", but the extent of disease was much less here.

This atypical ROP could be called prematurity exacerbated retinopathy. It probably represents a sub-clinical sporadic FEVR abnormality that we have not yet detected. She would have detached had she not been accidentally screened.