International Classification of Retinopathy of Prematurity, Third Edition

The International Classification of Retinopathy of Prematurity is a consensus statement that creates a standard nomenclature for classification of retinopathy of prematurity (ROP). It was initially published in 1984, expanded in 1987, and revisited in 2005. This article presents a third revision, th...

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Vydané v:Ophthalmology (Rochester, Minn.) Ročník 128; číslo 10; s. e51
Hlavní autori: Chiang, Michael F, Quinn, Graham E, Fielder, Alistair R, Ostmo, Susan R, Paul Chan, R V, Berrocal, Audina, Binenbaum, Gil, Blair, Michael, Peter Campbell, J, Capone, Jr, Antonio, Chen, Yi, Dai, Shuan, Ells, Anna, Fleck, Brian W, Good, William V, Elizabeth Hartnett, M, Holmstrom, Gerd, Kusaka, Shunji, Kychenthal, Andrés, Lepore, Domenico, Lorenz, Birgit, Martinez-Castellanos, Maria Ana, Özdek, Şengül, Ademola-Popoola, Dupe, Reynolds, James D, Shah, Parag K, Shapiro, Michael, Stahl, Andreas, Toth, Cynthia, Vinekar, Anand, Visser, Linda, Wallace, David K, Wu, Wei-Chi, Zhao, Peiquan, Zin, Andrea
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States 01.10.2021
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ISSN:1549-4713, 1549-4713
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Abstract The International Classification of Retinopathy of Prematurity is a consensus statement that creates a standard nomenclature for classification of retinopathy of prematurity (ROP). It was initially published in 1984, expanded in 1987, and revisited in 2005. This article presents a third revision, the International Classification of Retinopathy of Prematurity, Third Edition (ICROP3), which is now required because of challenges such as: (1) concerns about subjectivity in critical elements of disease classification; (2) innovations in ophthalmic imaging; (3) novel pharmacologic therapies (e.g., anti-vascular endothelial growth factor agents) with unique regression and reactivation features after treatment compared with ablative therapies; and (4) recognition that patterns of ROP in some regions of the world do not fit neatly into the current classification system. Review of evidence-based literature, along with expert consensus opinion. International ROP expert committee assembled in March 2019 representing 17 countries and comprising 14 pediatric ophthalmologists and 20 retinal specialists, as well as 12 women and 22 men. The committee was initially divided into 3 subcommittees-acute phase, regression or reactivation, and imaging-each of which used iterative videoconferences and an online message board to identify key challenges and approaches. Subsequently, the entire committee used iterative videoconferences, 2 in-person multiday meetings, and an online message board to develop consensus on classification. Consensus statement. The ICROP3 retains current definitions such as zone (location of disease), stage (appearance of disease at the avascular-vascular junction), and circumferential extent of disease. Major updates in the ICROP3 include refined classification metrics (e.g., posterior zone II, notch, subcategorization of stage 5, and recognition that a continuous spectrum of vascular abnormality exists from normal to plus disease). Updates also include the definition of aggressive ROP to replace aggressive-posterior ROP because of increasing recognition that aggressive disease may occur in larger preterm infants and beyond the posterior retina, particularly in regions of the world with limited resources. ROP regression and reactivation are described in detail, with additional description of long-term sequelae. These principles may improve the quality and standardization of ROP care worldwide and may provide a foundation to improve research and clinical care.
AbstractList The International Classification of Retinopathy of Prematurity is a consensus statement that creates a standard nomenclature for classification of retinopathy of prematurity (ROP). It was initially published in 1984, expanded in 1987, and revisited in 2005. This article presents a third revision, the International Classification of Retinopathy of Prematurity, Third Edition (ICROP3), which is now required because of challenges such as: (1) concerns about subjectivity in critical elements of disease classification; (2) innovations in ophthalmic imaging; (3) novel pharmacologic therapies (e.g., anti-vascular endothelial growth factor agents) with unique regression and reactivation features after treatment compared with ablative therapies; and (4) recognition that patterns of ROP in some regions of the world do not fit neatly into the current classification system. Review of evidence-based literature, along with expert consensus opinion. International ROP expert committee assembled in March 2019 representing 17 countries and comprising 14 pediatric ophthalmologists and 20 retinal specialists, as well as 12 women and 22 men. The committee was initially divided into 3 subcommittees-acute phase, regression or reactivation, and imaging-each of which used iterative videoconferences and an online message board to identify key challenges and approaches. Subsequently, the entire committee used iterative videoconferences, 2 in-person multiday meetings, and an online message board to develop consensus on classification. Consensus statement. The ICROP3 retains current definitions such as zone (location of disease), stage (appearance of disease at the avascular-vascular junction), and circumferential extent of disease. Major updates in the ICROP3 include refined classification metrics (e.g., posterior zone II, notch, subcategorization of stage 5, and recognition that a continuous spectrum of vascular abnormality exists from normal to plus disease). Updates also include the definition of aggressive ROP to replace aggressive-posterior ROP because of increasing recognition that aggressive disease may occur in larger preterm infants and beyond the posterior retina, particularly in regions of the world with limited resources. ROP regression and reactivation are described in detail, with additional description of long-term sequelae. These principles may improve the quality and standardization of ROP care worldwide and may provide a foundation to improve research and clinical care.
The International Classification of Retinopathy of Prematurity is a consensus statement that creates a standard nomenclature for classification of retinopathy of prematurity (ROP). It was initially published in 1984, expanded in 1987, and revisited in 2005. This article presents a third revision, the International Classification of Retinopathy of Prematurity, Third Edition (ICROP3), which is now required because of challenges such as: (1) concerns about subjectivity in critical elements of disease classification; (2) innovations in ophthalmic imaging; (3) novel pharmacologic therapies (e.g., anti-vascular endothelial growth factor agents) with unique regression and reactivation features after treatment compared with ablative therapies; and (4) recognition that patterns of ROP in some regions of the world do not fit neatly into the current classification system.PURPOSEThe International Classification of Retinopathy of Prematurity is a consensus statement that creates a standard nomenclature for classification of retinopathy of prematurity (ROP). It was initially published in 1984, expanded in 1987, and revisited in 2005. This article presents a third revision, the International Classification of Retinopathy of Prematurity, Third Edition (ICROP3), which is now required because of challenges such as: (1) concerns about subjectivity in critical elements of disease classification; (2) innovations in ophthalmic imaging; (3) novel pharmacologic therapies (e.g., anti-vascular endothelial growth factor agents) with unique regression and reactivation features after treatment compared with ablative therapies; and (4) recognition that patterns of ROP in some regions of the world do not fit neatly into the current classification system.Review of evidence-based literature, along with expert consensus opinion.DESIGNReview of evidence-based literature, along with expert consensus opinion.International ROP expert committee assembled in March 2019 representing 17 countries and comprising 14 pediatric ophthalmologists and 20 retinal specialists, as well as 12 women and 22 men.PARTICIPANTSInternational ROP expert committee assembled in March 2019 representing 17 countries and comprising 14 pediatric ophthalmologists and 20 retinal specialists, as well as 12 women and 22 men.The committee was initially divided into 3 subcommittees-acute phase, regression or reactivation, and imaging-each of which used iterative videoconferences and an online message board to identify key challenges and approaches. Subsequently, the entire committee used iterative videoconferences, 2 in-person multiday meetings, and an online message board to develop consensus on classification.METHODSThe committee was initially divided into 3 subcommittees-acute phase, regression or reactivation, and imaging-each of which used iterative videoconferences and an online message board to identify key challenges and approaches. Subsequently, the entire committee used iterative videoconferences, 2 in-person multiday meetings, and an online message board to develop consensus on classification.Consensus statement.MAIN OUTCOME MEASURESConsensus statement.The ICROP3 retains current definitions such as zone (location of disease), stage (appearance of disease at the avascular-vascular junction), and circumferential extent of disease. Major updates in the ICROP3 include refined classification metrics (e.g., posterior zone II, notch, subcategorization of stage 5, and recognition that a continuous spectrum of vascular abnormality exists from normal to plus disease). Updates also include the definition of aggressive ROP to replace aggressive-posterior ROP because of increasing recognition that aggressive disease may occur in larger preterm infants and beyond the posterior retina, particularly in regions of the world with limited resources. ROP regression and reactivation are described in detail, with additional description of long-term sequelae.RESULTSThe ICROP3 retains current definitions such as zone (location of disease), stage (appearance of disease at the avascular-vascular junction), and circumferential extent of disease. Major updates in the ICROP3 include refined classification metrics (e.g., posterior zone II, notch, subcategorization of stage 5, and recognition that a continuous spectrum of vascular abnormality exists from normal to plus disease). Updates also include the definition of aggressive ROP to replace aggressive-posterior ROP because of increasing recognition that aggressive disease may occur in larger preterm infants and beyond the posterior retina, particularly in regions of the world with limited resources. ROP regression and reactivation are described in detail, with additional description of long-term sequelae.These principles may improve the quality and standardization of ROP care worldwide and may provide a foundation to improve research and clinical care.CONCLUSIONSThese principles may improve the quality and standardization of ROP care worldwide and may provide a foundation to improve research and clinical care.
Author Shapiro, Michael
Fleck, Brian W
Lepore, Domenico
Blair, Michael
Vinekar, Anand
Ells, Anna
Kusaka, Shunji
Özdek, Şengül
Dai, Shuan
Fielder, Alistair R
Chiang, Michael F
Berrocal, Audina
Lorenz, Birgit
Wallace, David K
Good, William V
Ademola-Popoola, Dupe
Chen, Yi
Holmstrom, Gerd
Stahl, Andreas
Capone, Jr, Antonio
Elizabeth Hartnett, M
Toth, Cynthia
Wu, Wei-Chi
Quinn, Graham E
Kychenthal, Andrés
Binenbaum, Gil
Peter Campbell, J
Ostmo, Susan R
Visser, Linda
Paul Chan, R V
Martinez-Castellanos, Maria Ana
Reynolds, James D
Zhao, Peiquan
Shah, Parag K
Zin, Andrea
Author_xml – sequence: 1
  givenname: Michael F
  surname: Chiang
  fullname: Chiang, Michael F
  email: michael.chiang@nih.gov
  organization: National Eye Institute, National Institutes of Health, Bethesda, Maryland. Electronic address: michael.chiang@nih.gov
– sequence: 2
  givenname: Graham E
  surname: Quinn
  fullname: Quinn, Graham E
  organization: Division of Ophthalmology, Children's Hospital of Philadelphia, Scheie Eye Institute, Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
– sequence: 3
  givenname: Alistair R
  surname: Fielder
  fullname: Fielder, Alistair R
  organization: Department of Optometry and Visual Science, University of London, London, United Kingdom
– sequence: 4
  givenname: Susan R
  surname: Ostmo
  fullname: Ostmo, Susan R
  organization: Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
– sequence: 5
  givenname: R V
  surname: Paul Chan
  fullname: Paul Chan, R V
  organization: Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois
– sequence: 6
  givenname: Audina
  surname: Berrocal
  fullname: Berrocal, Audina
  organization: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
– sequence: 7
  givenname: Gil
  surname: Binenbaum
  fullname: Binenbaum, Gil
  organization: Division of Ophthalmology, Children's Hospital of Philadelphia, Scheie Eye Institute, Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
– sequence: 8
  givenname: Michael
  surname: Blair
  fullname: Blair, Michael
  organization: Retina Consultants, Ltd., Des Plaines, Illinois; Department of Ophthalmology, University of Chicago, Chicago, Illinois
– sequence: 9
  givenname: J
  surname: Peter Campbell
  fullname: Peter Campbell, J
  organization: Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
– sequence: 10
  givenname: Antonio
  surname: Capone, Jr
  fullname: Capone, Jr, Antonio
  organization: Associated Retinal Consultants, PC, Royal Oak, Michigan, and Department of Ophthalmology, Oakland University, William Beaumont Hospital School of Medicine, Auburn Hills, Michigan
– sequence: 11
  givenname: Yi
  surname: Chen
  fullname: Chen, Yi
  organization: Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China
– sequence: 12
  givenname: Shuan
  surname: Dai
  fullname: Dai, Shuan
  organization: Ophthalmology Department, Queensland Children's Hospital, Brisbane, Australia
– sequence: 13
  givenname: Anna
  surname: Ells
  fullname: Ells, Anna
  organization: Calgary Retina Consultants, Calgary, Canada
– sequence: 14
  givenname: Brian W
  surname: Fleck
  fullname: Fleck, Brian W
  organization: Department of Ophthalmology, University of Edinburgh, Edinburgh, United Kingdom
– sequence: 15
  givenname: William V
  surname: Good
  fullname: Good, William V
  organization: Smith-Kettlewell Eye Research Institute, San Francisco, California
– sequence: 16
  givenname: M
  surname: Elizabeth Hartnett
  fullname: Elizabeth Hartnett, M
  organization: Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
– sequence: 17
  givenname: Gerd
  surname: Holmstrom
  fullname: Holmstrom, Gerd
  organization: Department Neuroscience/Ophthalmology, Uppsala University, Uppsala, Sweden
– sequence: 18
  givenname: Shunji
  surname: Kusaka
  fullname: Kusaka, Shunji
  organization: Department of Ophthalmology, Kindai University, Osakasayama, Japan
– sequence: 19
  givenname: Andrés
  surname: Kychenthal
  fullname: Kychenthal, Andrés
  organization: Department of Ophthalmology, KYDOFT Foundation, Santiago, Chile
– sequence: 20
  givenname: Domenico
  surname: Lepore
  fullname: Lepore, Domenico
  organization: A. Gemelli Foundation IRCSS, Department of Ageing and Neuroscience, Catholic University of the Sacred Heart, Rome, Italy
– sequence: 21
  givenname: Birgit
  surname: Lorenz
  fullname: Lorenz, Birgit
  organization: Department of Ophthalmology, Justus-Liebig-University Giessen, Giessen, Germany; Department of Ophthalmology, Universitaetsklinikum Bonn, Bonn, Germany
– sequence: 22
  givenname: Maria Ana
  surname: Martinez-Castellanos
  fullname: Martinez-Castellanos, Maria Ana
  organization: Retina Department, Asociación para Evitar la Ceguera en México, Mexico City, Mexico
– sequence: 23
  givenname: Şengül
  surname: Özdek
  fullname: Özdek, Şengül
  organization: Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey
– sequence: 24
  givenname: Dupe
  surname: Ademola-Popoola
  fullname: Ademola-Popoola, Dupe
  organization: Department of Ophthalmology, University of Ilorin, Ilorin, Nigeria
– sequence: 25
  givenname: James D
  surname: Reynolds
  fullname: Reynolds, James D
  organization: Ross Eye Institute, Department of Ophthalmology, University at Buffalo, Buffalo, New York
– sequence: 26
  givenname: Parag K
  surname: Shah
  fullname: Shah, Parag K
  organization: Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
– sequence: 27
  givenname: Michael
  surname: Shapiro
  fullname: Shapiro, Michael
  organization: Retina Consultants, Ltd., Des Plaines, Illinois
– sequence: 28
  givenname: Andreas
  surname: Stahl
  fullname: Stahl, Andreas
  organization: Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
– sequence: 29
  givenname: Cynthia
  surname: Toth
  fullname: Toth, Cynthia
  organization: Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
– sequence: 30
  givenname: Anand
  surname: Vinekar
  fullname: Vinekar, Anand
  organization: Department of Pediatric Retina, Narayana Nethralaya Eye Institute, Bangalore, Karnataka, India
– sequence: 31
  givenname: Linda
  surname: Visser
  fullname: Visser, Linda
  organization: Department of Ophthalmology, University of KwaZulu-Natal, Durban, South Africa
– sequence: 32
  givenname: David K
  surname: Wallace
  fullname: Wallace, David K
  organization: Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana
– sequence: 33
  givenname: Wei-Chi
  surname: Wu
  fullname: Wu, Wei-Chi
  organization: Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan, and Chang Gung University, College of Medicine, Taoyuan, Taiwan
– sequence: 34
  givenname: Peiquan
  surname: Zhao
  fullname: Zhao, Peiquan
  organization: Department of Ophthalmology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
– sequence: 35
  givenname: Andrea
  surname: Zin
  fullname: Zin, Andrea
  organization: Clinical Research Unit, Fernandes Figueira Institute, FIOCRUZ, Rio de Janeiro, Brazil
BackLink https://www.ncbi.nlm.nih.gov/pubmed/34247850$$D View this record in MEDLINE/PubMed
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Keywords Neonatology
Retina
Retinopathy of prematurity
Prematurity
Pediatric ophthalmology
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References 34332760 - Ophthalmology. 2021 Oct;128(10):1381-1383
35256217 - Ophthalmology. 2022 Jun;129(6):e64-e65
34844764 - Ophthalmology. 2022 Mar;129(3):e36
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Snippet The International Classification of Retinopathy of Prematurity is a consensus statement that creates a standard nomenclature for classification of retinopathy...
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SubjectTerms Diagnostic Imaging
Disease Progression
Gestational Age
Humans
Infant, Newborn
Retina - diagnostic imaging
Retinopathy of Prematurity - classification
Retinopathy of Prematurity - diagnosis
Title International Classification of Retinopathy of Prematurity, Third Edition
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Volume 128
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