{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T04:38:08Z","timestamp":1775018288377,"version":"3.50.1"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,4]],"date-time":"2024-05-04T00:00:00Z","timestamp":1714780800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,4]],"date-time":"2024-05-04T00:00:00Z","timestamp":1714780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004156","name":"Mahidol University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004156","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We present a patient with retinopathy of prematurity (ROP) who developed worsening plus disease after complete regression of stage 3 ROP. The use of fundus fluorescein angiography (FFA) aided the visualization of occult neovascularization that caused the disease progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>The patient was at high risk for ROP due to low birth weight of 690\u00a0g and gestational age of 25 weeks. After the diagnosis of stage 3 ROP in zone I without plus disease, she was treated initially with bilateral intravitreal bevacizumab (IVB) and followed by laser photocoagulation 5 weeks later. Despite the resolution of ROP stage, the plus disease worsened. Neither systemic risk factors nor skip laser areas were observed. Hence, FFA was performed and subsequently identified occult neovascularization with active leakage. Additional IVB and laser treatment in the capillary dropout area inside vascularized retina were added. The plus disease improved but mild arteriolar tortuosity persisted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Worsening of plus disease after completion of laser ablation and IVB with complete regression of stage 3 ROP is rare. Systemic risk factors such as continuous oxygen therapy and cardiovascular disease should be ruled out. FFA aided in identifying occult neovascularization and prompted further treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12887-024-04784-1","type":"journal-article","created":{"date-parts":[[2024,5,4]],"date-time":"2024-05-04T01:01:39Z","timestamp":1714784499000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Occult retinal neovascularization following intravitreal bevacizumab and laser treatment for retinopathy of prematurity"],"prefix":"10.1186","volume":"24","author":[{"given":"Wei Loon","family":"Ng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adisak","family":"Trinavarat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"La-ongsri","family":"Atchaneeyasakul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,5,4]]},"reference":[{"issue":"1","key":"4784_CR1","first-page":"26","volume":"3","author":"PG Steinkuller","year":"1999","unstructured":"Steinkuller PG, Du L, Gilbert C, Foster A, Collins ML, Coats DK. Childhood blindness. J APPOS. 1999;3(1):26\u201332.","journal-title":"J APPOS"},{"issue":"12","key":"4784_CR2","doi-asserted-by":"publisher","first-page":"1684","DOI":"10.1001\/archopht.121.12.1684","volume":"121","author":"WV Good","year":"2003","unstructured":"Good WV, Hardy RJ, Dobson V, Palmer E. Revised indications for the treatment of retinopathy of prematurity- results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol. 2003;121(12):1684\u201396.","journal-title":"Arch Ophthalmol"},{"issue":"3","key":"4784_CR3","first-page":"152","volume":"7","author":"G Layla","year":"2018","unstructured":"Layla G, Sang JK, Pier J. Plus disease in retinopathy of prematurity: more than meets the ICROP. Asia Pac J Ophthalmol (Phila). 2018;7(3):152\u20135.","journal-title":"Asia Pac J Ophthalmol (Phila)"},{"issue":"5","key":"4784_CR4","doi-asserted-by":"publisher","first-page":"764","DOI":"10.5301\/ejo.5000295","volume":"23","author":"YMP Darius","year":"2013","unstructured":"Yannis MP, Darius MM. Persistent plus disease after laser in retinopathy of prematurity with tetralogy of Fallot. Eur J Ophthalmol. 2013;23(5):764\u20136.","journal-title":"Eur J Ophthalmol"},{"key":"4784_CR5","doi-asserted-by":"crossref","unstructured":"Mintz-Hittner HA, Kennedy KA, Chuang AZ, BEAT-ROP Cooperative Group. Efficacy of intravitreal bevacizumab for stage 3\u2009+\u2009retinopathy of prematurity. N Engl J Med. 2011:364(7):603\u201315.","DOI":"10.1056\/NEJMoa1007374"},{"issue":"10208","key":"4784_CR6","doi-asserted-by":"publisher","first-page":"1551","DOI":"10.1016\/S0140-6736(19)31344-3","volume":"394","author":"A Stahl","year":"2019","unstructured":"Stahl A, Lepore D, Fielder A, et al. Ranibizumab versus laser therapy for the treatment of very low birthweight infants with retinopathy of prematurity (RAINBOW): an open-label randomised controlled trial. Lancet (London England). 2019;394(10208):1551\u20139.","journal-title":"Lancet (London England)"},{"issue":"3","key":"4784_CR7","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1038\/eye.2015.289","volume":"30","author":"M Isaac","year":"2016","unstructured":"Isaac M, Tehranin N, Mireskandari K. Involution patterns of retinopathy of prematurity after treatment with intravitreal Bevacizumab: implications for follow up. Eye (Lond). 2016;30(3):333\u201341.","journal-title":"Eye (Lond)"},{"issue":"10","key":"4784_CR8","doi-asserted-by":"publisher","first-page":"1700","DOI":"10.1016\/S0161-6420(79)35329-5","volume":"86","author":"JT Flynn","year":"1979","unstructured":"Flynn JT, Cassady J, Essner D, et al. Fluorescein angiography in retrolental fibroplasia: experience from 1969\u20131977. Ophthalmology. 1979;86(10):1700\u201323.","journal-title":"Ophthalmology"},{"issue":"5","key":"4784_CR9","doi-asserted-by":"publisher","first-page":"282","DOI":"10.3928\/01913913-20130528-04","volume":"50","author":"KB Kang","year":"2013","unstructured":"Kang KB, Wessel MM, Tong J, D\u2019Amico DJ, Chan RV. Ultra-wide- field imaging for the management of paediatric retinal diseases. J Pediatr Ophthalmol Strabismus. 2013;50(5):282\u20138.","journal-title":"J Pediatr Ophthalmol Strabismus"},{"issue":"8","key":"4784_CR10","doi-asserted-by":"publisher","first-page":"1601","DOI":"10.1016\/j.ophtha.2015.04.023","volume":"122","author":"MA Klufas","year":"2015","unstructured":"Klufas MA, Patel SN, Ryan MC, et al. Influence of fluorescein angiography on the diagnosis and management of retinopathy of pre-maturity. Ophthalmology. 2015;122(8):1601\u20138.","journal-title":"Ophthalmology"}],"container-title":["BMC Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-024-04784-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12887-024-04784-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-024-04784-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,4]],"date-time":"2024-05-04T01:01:45Z","timestamp":1714784505000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpediatr.biomedcentral.com\/articles\/10.1186\/s12887-024-04784-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,4]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4784"],"URL":"https:\/\/doi.org\/10.1186\/s12887-024-04784-1","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3362736\/v1","asserted-by":"object"}]},"ISSN":["1471-2431"],"issn-type":[{"value":"1471-2431","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,4]]},"assertion":[{"value":"17 September 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This case report had obtained approval and consent from ethical review board of Faculty of Medicine, Hospital Siriraj, Thailand.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written consent for participation and publication were obtained from the legal guardian (mother) of the patient.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"301"}}