Comment on ‘Posterior to the ridge laser in zone 2 stage 3 retinopathy of prematurity with plus disease: Efficacy and safety’

Dear Editor, The authors of ‘Posterior to the ridge laser in zone 2 stage 3 retinopathy of prematurity with plus disease: Efficacy and safety’ have done a commendable job.[1] However, the classification used for grouping their data, that is, stage 3 prethreshold and threshold, was not given by the ETROP group as cited.[2] In fact, the term ‘threshold ROP’ was provided by the Cryo-ROP group in a system of classification that is outdated today.[3] Essentially, the difference between both the systems of classifications was the clock-hour extent of ROP (retinopathy of prematurity) ridge. These clock hours are not considered in the latest systems for ROP classification or treatment.[2,4] Hence, it is difficult to envision two groups from two different systems of classification. The authors have summarized the outcomes in relation to clock hours of stage 3 ROP. The same could have been done for creating groups. Under the ‘results’ section, they could also have described the morphological features of the stage 3 ridge in which they did posterior laser. This could have included high ridge, aggressive plus, rope-like vessels, serous retinal detachment surrounding the ridge, and hemorrhages on or posterior to the ridge. This would have greatly assisted the physicians to practice discretion in lasering the retina immediately posterior to the ridge. The authors too would agree that lasering the retina posterior to zone 2 stage 3 ridge is not necessary in all cases. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.