Peds Ophtho Case 4: Dilated Fundus Exam

Peds Ophtho Case 4 Index

Answer: Wavy and elevated vascularized line (ridge) between vascular and avascular retina with tortuous vessels. 

ROP LE arrpws

Figure legend: Purple arrow – Tortuous vessels (plus disease). Blue arrow – ridge between vascular and avascular retina.

Dilated Fundus Exam (DFE) Findings:

In the left eye (above), there is normal retinal vasculature that extends into Zone II with moderate tortuosity and plus disease. The macula is not distorted. A three-dimensional vascular ridge is seen between the vascular and avascular retina. Neovascularization is also observed.

Findings in the right eye (below) are similar to the left eye and represent a more severe form of stage III ROP with the presence of vitreous hemorrhage.

Above Images courtesy of Robin Ginsburg, MD

What are possible complications of ROP? Select all that apply.
Primary open angle glaucoma
Retinal detachment
Juvenile macular degeneration
Posterior uveitis
Retinitis pigmentosa


In terms of therapy, what is the next best step?
Atropine eye drops 
Anti-vascular endothelial growth factor (anti-VEGF) injection
Betamethasone ointment
Diclofenac eye drops
Eye patching
Prostaglandin analogue

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Peds Ophtho Case 4 Index
Peds Ophtho Case 4: Introduction
Peds Ophtho Case 4: Additional History & Physical Exam