New grading description for ROP retinal changes for those meeting termination of vision screening guidelines
Reviewed by Fiona Rowe

This study reports and characterises residual retinal changes seen in eyes that meet criteria for termination of acute retinal screening exams. A novel grading system was used in which retinal exams were graded A to E. ‘A’ was defined as a mature retina with complete retinal vasculature to within at least one disc diameter of the temporal ora and no residual fibrotic tissue grade E had residual vascular tissue within fibrotic tissue, considered most active and most concerning. This was a retrospective review of 521 consecutive infant records from January 2016 to June 2019. One-hundred and thirty-one infants were identified; 255 eyes. Final ROP screening indicated 81% with persistent avascular retina. 45/49 had no persistent avascular retina, graded A and four were graded C. 153/206 were graded B and 53 graded C/D. None were graded E. The authors report the grading system as easy to use, providing a standardised approach to describing / grading residual retinal findings and to be used with binocular indirect ophthalmoscopy or retinal fundus photographs. They note their data were limited to the acute phase of ROP and therefore, no conclusions were provided for long-term risk.

Characteristics of spontaneously regressed ROP at termination of acute retinal screening exams using a novel grading system.
Ness PJ, Andaluz-Scher L, Leverant RM, et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2023;60:359–64.