Background: Retinopathy of Prematurity (ROP) is a leading cause of childhood blindness, with advanced stages like Stage IV-A presenting significant management challenges. While wide-field retinal imaging has revolutionized ROP screening, its utility in monitoring the detailed evolution of the disease, particularly in advanced stages, is not extensively documented. This study aims to illustrate the longitudinal progression of Stage IV-A ROP using serial retinal imaging.

Methods: This retrospective case series was conducted at a tertiary neonatal care center. Premature infants diagnosed with Stage IV-A ROP who underwent serial examinations with a wide-field infant retinal camera were included. A comprehensive review of their medical records and sequential retinal images was performed. The evolution of key pathological features, including the extent of retinal detachment, vascular abnormalities, and ridge characteristics, was documented and correlated with clinical management decisions.

Results: The case series details the clinical and imaging journey of infants with Stage IV-A ROP. The longitudinal images provided a dynamic view of the disease, revealing subtle yet critical changes in the retinal detachment and vascular activity that influenced the timing and choice of interventions, including laser photocoagulation and vitreoretinal surgery. The imaging data served as an objective tool for monitoring treatment response and guiding subsequent management steps.

Conclusion: Serial wide-field retinal imaging is an indispensable tool for the nuanced management of Stage IV-A ROP. It provides crucial, objective insights into disease dynamics that surpass traditional examinations, facilitating more precise and timely clinical decision-making. The integration of such technology into standard care protocols is vital for improving outcomes in this vulnerable population.

Retinopathy of Prematurity, Retinal Imaging, Stage IV-A ROP, Wide-Field Imaging

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