ROP develops from the center outward, and is described in stages and zones. Imagine the eye as a target, with the bullseye in the center. The zones refer to the distance away from the center, and the stages refer to how far the disease has progressed. Below is a cartoon of ROP that is in Zone 2, in both eyes. The AAP, in conjunction with the American Academy of Ophthalmology, has established guidelines for examination and treatment of ROP in premature babies, Screening Examination of Premature Infants for Retinopathy of Prematurity. PEDIATRICS, Vol. 117 No. 2 February 1, 2006 pp. 572 -576 (doi: 10.1542/peds.2005-2749) can be viewed in full via the internet (http://pediatrics.aappublications.org/content/117/2/572.full). Treatment consists of laser surgery to destroy the abnormally developing blood vessels, and is usually done in the NICU. Recently, a drug being used successfully in the treatment of colon and other cancers in adults, called Avastin®, has been undergoing experimental trials in some NICUs as treatment for ROP. The drug is injected into the blood vessels and stops their development. While the treatment looks promising for ROP, the long-term and systemic effects of this powerful drug on other parts of a developing premature baby’s body have yet to be fully understood.

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