OSN Europe: How do you manage children who have persistent plus disease or progressive ROP after laser or anti-VEGF treatment?

Various factors must be considered to decide the next step in the management of progression after treatment for type 1 ROP: type of primary treatment, zone and stage of disease. If there is persistent plus disease and no retinal detachment in an eye treated with laser for zone 2 ROP, treatment of skipped areas should be done. If adequate treatment was given (near confluent spots in all the avascular area), the use of an intravitreal anti-VEGF drug is advisable.If the eye had zone 1 ROP and was initially treated with laser, the secondary treatment would depend on the zone where the vessels are located. If vessels are still in zone 1, the injection of an intravitreal anti-VEGF drug could be performed. If vessels are in zone 2, more laser should be applied if skipped areas are found.