The natural history of active retinopathy of prematurity.

Two hundred twenty-one premature infants were examined in the premature nursery. Thirty-seven of the 221 (16.2%) had retinopathy of prematurity (ROP). Eight patients (21.5%) went blind and three other infants lost sight in one eye for a total of 19 sightless eyes (25.7%). The remaining 55 eyes (74.3%) retained vision. Birth weight was the most critical prognostic factor. Of eight babies who became blind all were under 1000 grams at birth, while babies who showed little change from active ROP were generally over 1300 grams. Nine of 14 eyes with only peripheral shunts (64%) resolved without dragging of the retina in the posterior pole. Sixteen eyes developed peripheral retinal detachment, and six of the sixteen (37.4%) had associated dilation and tortuosity of vessels in the posterior pole. Only one of these eyes resolved with minimal sequelae, suggesting that peripheral retinal detachment with dilated tortuous vessels was the most significant indicator of serious consequences.