Primary exudative retinal detachment in stage 4b retinopathy of prematurity managed nonsurgically – A case report

Preterm baby born at 30 weeks of gestation presented at 3 weeks with zone 1 stage 3 retinopathy of prematurity (ROP) with plus disease in the right eye and zone 1 stage 4b ROP with plus disease in the left eye. We report this rare primary presentation of exudative retinal detachment in ROP in the left eye managed by concurrent laser photocoagulation and intravitreal injection anti-VEGF. ROP regressed completely in 6 weeks. The right eye was managed similarly. Stage 4b ROP usually requires surgical intervention. We report this rare presentation managed nonsurgically with good prognosis.