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Introduction
Retinopathy of prematurity (ROP), one of the leading causes of blindness in children, affects retinal vascular development and may lead to extraretinal fibrovascular proliferation (EFP), macular dragging, and, in severe cases, tractional retinal detachment (TRD).1 Early identification, appropriate treatment, and close monitoring are necessary to prevent blindness. Laser ablation and more recently intravitreal anti-vascular endothelial growth factor (VEGF) injections were shown to be effective treatment options for ROP.2,3 Rare cases of exudative retinal detachments (ERD) decades after acute stages of ROP have been reported in literature as late sequelae of ROP.4–6 This late reactivation is likely due to low-level but persistent secretion of VEGF by avascular retina, similar to many other diseases with nonperfused retina. There is controversy regarding the need to treat persistent peripheral avascular retina in regressed ROP, particularly after anti-VEGF treatment, because traditionally avascular retina has not been treated after spontaneously regressed ROP. Herein, a case of unilateral retinal detachment in a 19-year-old with history of treated ROP in the contralateral eye is reported.
Case Report
A 19-year-old female was referred with blurred vision and floaters in the right eye. At presentation, visual acuity (VA) was count fingers in the right eye and 20/200 in the left eye, with intraocular pressures of 27 mm Hg and 23 mm Hg, respectively. Anterior segment exam was normal. Dilated fundus exam revealed mild vitreous hemorrhage, macular heterotopia, and exudates with temporally dragged vessels in the right eye. Additionally, peripheral retina was detached in the right eye, with exudates and radial vessels emanating from the area of regressed EFP to a new anterior area of EFP (Figure 1). The left eye had nasal dragging of the fovea with vascular tortuosity and attached retina with 360° peripheral panretinal laser treatment (Figure 2). Fluorescein angiography (FA) showed temporal areas of nonperfusion and microaneurysms, as well as areas of leakage from EFP at the edge of nonperfusion zone in the right eye (Figure 3). The left eye had...