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Abstract：
The International Classification of Retinopathy of Prematurity is a consensus statement that creates a standard nomenclature for classification of retinopathy of prematurity (ROP). It was initially published in 1984, expanded in 1987, and revisited in 2005. This article presents a third revision, the International Classification of Retinopathy of Prematurity, Third Edition (ICROP3), which is now required because of challenges such as: (1) concerns about subjectivity in critical elements of disease classification; (2) innovations in ophthalmic imaging; (3) novel pharmacologic therapies (e.g., anti-vascular endothelial growth factor agents) with unique regression and reactivation features after treatment compared with ablative therapies; and (4) recognition that patterns of ROP in some regions of the world do not fit neatly into the current classification system.
Review of evidence-based literature, along with expert consensus opinion.
International ROP expert committee assembled in March 2019 representing 17 countries and comprising 14 pediatric ophthalmologists and 20 retinal specialists, as well as 12 women and 22 men.
The committee was initially divided into 3 subcommittees-acute phase, regression or reactivation, and imaging-each of which used iterative videoconferences and an online message board to identify key challenges and approaches. Subsequently, the entire committee used iterative videoconferences, 2 in-person multiday meetings, and an online message board to develop consensus on classification.
Consensus statement.
The ICROP3 retains current definitions such as zone (location of disease), stage (appearance of disease at the avascular-vascular junction), and circumferential extent of disease. Major updates in the ICROP3 include refined classification metrics (e.g., posterior zone II, notch, subcategorization of stage 5, and recognition that a continuous spectrum of vascular abnormality exists from normal to plus disease). Updates also include the definition of aggressive ROP to replace aggressive-posterior ROP because of increasing recognition that aggressive disease may occur in larger preterm infants and beyond the posterior retina, particularly in regions of the world with limited resources. ROP regression and reactivation are described in detail, with additional description of long-term sequelae.
These principles may improve the quality and standardization of ROP care worldwide and may provide a foundation to improve research and clinical care.
Review of evidence-based literature, along with expert consensus opinion.
International ROP expert committee assembled in March 2019 representing 17 countries and comprising 14 pediatric ophthalmologists and 20 retinal specialists, as well as 12 women and 22 men.
The committee was initially divided into 3 subcommittees-acute phase, regression or reactivation, and imaging-each of which used iterative videoconferences and an online message board to identify key challenges and approaches. Subsequently, the entire committee used iterative videoconferences, 2 in-person multiday meetings, and an online message board to develop consensus on classification.
Consensus statement.
The ICROP3 retains current definitions such as zone (location of disease), stage (appearance of disease at the avascular-vascular junction), and circumferential extent of disease. Major updates in the ICROP3 include refined classification metrics (e.g., posterior zone II, notch, subcategorization of stage 5, and recognition that a continuous spectrum of vascular abnormality exists from normal to plus disease). Updates also include the definition of aggressive ROP to replace aggressive-posterior ROP because of increasing recognition that aggressive disease may occur in larger preterm infants and beyond the posterior retina, particularly in regions of the world with limited resources. ROP regression and reactivation are described in detail, with additional description of long-term sequelae.
These principles may improve the quality and standardization of ROP care worldwide and may provide a foundation to improve research and clinical care.
摘要：
国际早产儿视网膜病变分类是一项共识声明，为早产儿视网膜病变（ROP）的分类创建了标准命名法。它最初于1984年出版，于1987年扩展，并于2005年重新审视。本文提出了第三次修订，国际早产儿视网膜病变分类，第三版(ICROP3)现在需要这样的挑战，例如：（1）对疾病分类关键要素的主观性的担忧；（2）眼科成像的创新；（3）新颖的药物疗法（例如，抗血管内皮生长因子药物）与消融疗法相比，具有治疗后独特的消退和再激活特征；（4）认识到世界某些地区的ROP模式不完全适合当前的分类系统。
循证文献综述，以及专家共识意见。国际ROP专家委员会于2019年3月组成，代表17个国家，由14名儿科眼科医生和20名视网膜专家组成。还有12个女人和22个男人.
该委员会最初分为3个小组委员会-急性期，回归或重新激活，和成像-每个都使用迭代视频会议和在线留言板来确定关键挑战和方法。随后，整个委员会使用了反复的视频会议，2个面对面的多天会议，和一个在线留言板，以就分类达成共识。
共识声明。
ICROP3保留了当前的定义，例如区域（疾病位置），阶段（在无血管-血管交界处出现疾病），和疾病的圆周范围。ICROP3中的主要更新包括完善的分类指标(例如，后区II,凹口,对第5阶段进行分类，并认识到从正常到增加疾病都存在连续的血管异常）。更新还包括侵袭性ROP的定义，以取代侵袭性后部ROP，因为越来越多的人认识到侵袭性疾病可能发生在较大的早产儿和后部视网膜以外，特别是在世界资源有限的地区。详细介绍了ROP回归和再激活，对长期后遗症的额外描述。
这些原则可能会提高世界范围内ROP护理的质量和标准化，并可能为改善研究和临床护理提供基础。
循证文献综述，以及专家共识意见。国际ROP专家委员会于2019年3月组成，代表17个国家，由14名儿科眼科医生和20名视网膜专家组成。还有12个女人和22个男人.
该委员会最初分为3个小组委员会-急性期，回归或重新激活，和成像-每个都使用迭代视频会议和在线留言板来确定关键挑战和方法。随后，整个委员会使用了反复的视频会议，2个面对面的多天会议，和一个在线留言板，以就分类达成共识。
共识声明。
ICROP3保留了当前的定义，例如区域（疾病位置），阶段（在无血管-血管交界处出现疾病），和疾病的圆周范围。ICROP3中的主要更新包括完善的分类指标(例如，后区II,凹口,对第5阶段进行分类，并认识到从正常到增加疾病都存在连续的血管异常）。更新还包括侵袭性ROP的定义，以取代侵袭性后部ROP，因为越来越多的人认识到侵袭性疾病可能发生在较大的早产儿和后部视网膜以外，特别是在世界资源有限的地区。详细介绍了ROP回归和再激活，对长期后遗症的额外描述。
这些原则可能会提高世界范围内ROP护理的质量和标准化，并可能为改善研究和临床护理提供基础。
