**5.4 Management**

Argon laser photocoagulation is performed in babies with threshold disease. Threshold disease is defined as 5 contiguous clock hours or 8 total clock hours of extraretinal neovascularisation located at or near the macula, which is the critical region of the retina for vision. Plus disease is also a feature of the threshold disease. It is defined as sausage like dilatations of the vessels around the optic disc, as a response to hypoxia. Posterior segment surgeries are indicated if retinal detachment occurs. The outcomes after laser therapy are successful in 85% of the cases, but they are not promising after surgery. Laser ablation of the avascular retina is applied to halt the progression of ROP. VEGF inhibitors alone or combined with laser therapy or surgery may be injected into the eyes to stop or slow the progression of the disease (Erol, 2011).

Pediatricians must be aware of the association between refractive disorders, amblyopia and strabismus in early or late childhood period and ROP. The risk of developing these disorders is correlated with the severity of ROP, but it still exists in regressed ROP cases with no sequel according to some literature. Therefore all ROP cases must be routinely referred to an ophthalmologist to screen for these possible associations.
