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Invited Commentary
June 2018

Plus Disease in Retinopathy of Prematurity—Investigating Its Definition

Author Affiliations
  • 1Wills Eye Hospital, Philadelphia, Pennsylvania
JAMA Ophthalmol. 2018;136(6):655-657. doi:10.1001/jamaophthalmol.2018.0543

The presence of plus disease in retinopathy of prematurity (ROP) is an important criterion for identifying ROP that requires treatment. Although the Cryotherapy for ROP and Early Treatment for ROP studies have created standardized guidelines for ROP classification, the definition of plus disease continues to evolve.1

In the Cryotherapy for ROP study, plus disease was defined as posterior venous dilation and arteriolar tortuosity that meets or exceeds the degree of abnormality represented in a reference photograph, which was selected by a consensus of ROP experts.1 In 2005, the international classification of ROP (ICROP) was revised and delineated that plus disease requires the presence of 2 or more quadrants of vascular abnormality.2