Late complications of retrolental fibroplasia.

A modified classification of cicatricial RLF has been presented. Particular emphasis is placed on myopia, one of the hallmarks of grade i cicatricial RLF. Whether or not this is axial myopia is still open to question, but since the more myopic eye was usually longer by ultrasonic measurement than the less myopic eye, actual enlargement of the eye must play some role. Other features noted in grade I RLF were retinal pigmentation, vitreous membranes, and equatorial retinal folds. In grade II the most significant finding was dragging of the retina. It was noted that in all cases of dragging of the retina there were also peripheral retinal changes. Even more important, however, was the fact that peripheral retinal changes are often present when there are no changes in the posterior pole. Neovascularization, elevated retinal vessels, lattice degeneration, and retinal breaks were other features of grade II retinopathy. Significant was the fact that the incidence of lattice in patients with cicatricial RLF (15%) was more than twice that of the normal population. Grade III RLF was characterized by falciform retinal folds, and grade IV, by retinal detachment. Thirty-nine retinal detachments were rhegmatogenous and usually had temporal retinal breaks. Retinal detachments of a tractional exudative variety (14 eyes) tended to occur earlier in life than the rhegmatogenous variety. In infants, they were preceded by increased tortuosity of the vessels in the posterior pole and, sometimes, accumulation of exudation, both ominous prognostic signs.