Retinopathy of prematurity (ROP) zone I, stage 3+ disease is found on screening. Based on ET-ROP (Early Treatment of Retinopathy of Prematurity) study results, what is the preferred primary treatment?

• A Cryotherapy to the avascular retina
• B Intravitreal anti-VEGF (bevacizumab or ranibizumab) ✓
• C Diode laser photocoagulation to the avascular zone
• D Scleral buckling surgery

Explanation

For zone I ROP (posterior pole involvement), intravitreal anti-VEGF therapy — particularly bevacizumab (BEAT-ROP study) or ranibizumab (RAINBOW trial) — has become the preferred treatment over laser photocoagulation due to its superior outcomes in zone I disease. Zone I is close to the optic disc and fovea; laser in this zone can destroy visual field. Laser remains preferred for zone II ROP. Anti-VEGF does not permanently ablate retinal vessels, requiring long-term follow-up for late reactivation.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.