Baby born premature at 29 wks on examination at 42 wks with ROP both eyes shows stage 2 zone I plus disease, how will you manage the natient?
**Core Concept**
Retinopathy of Prematurity (ROP) is a disease of the eye affecting prematurely born babies, characterized by abnormal growth of blood vessels in the retina. Stage 2 zone I plus disease indicates a high risk of progression to retinal detachment and blindness if left untreated.
**Why the Correct Answer is Right**
Laser photocoagulation is the standard treatment for ROP, especially in advanced stages like stage 2 zone I plus disease. This treatment involves creating small burns on the retina to stop the abnormal blood vessel growth and prevent further progression. In this case, both eyes are affected, so treating both eyes with laser photocoagulation is the most appropriate management strategy. The goal is to prevent retinal detachment and preserve vision in both eyes.
**Why Each Wrong Option is Incorrect**
**Option A:** Immediate follow-up after one week may be too late, as ROP can rapidly progress, leading to vision loss or blindness.
**Option C:** Focusing on the worse eye and following up the other eye may not address the high risk of progression in the untreated eye, potentially leading to vision loss in the untreated eye.
**Option D:** Vitreoretinal surgery may be considered in cases of retinal detachment, but it is not the primary treatment for ROP, especially in stage 2 zone I plus disease.
**Clinical Pearl / High-Yield Fact**
In ROP, timely treatment is critical to prevent vision loss. The "Plus disease" sign, characterized by dilation and tortuosity of posterior retinal blood vessels, is a high-risk feature that warrants aggressive treatment.
**✓ Correct Answer: B. Laser photocoagulation of both eyes**