In which stage of ROP can extraretinal neovascularization initially become severe enough to cause total retinal detachment?

• A. Stage 4
• B. Stage 2
• C. Stage 3
• D. Stage 5

Answer: (C)

In retinopathy of prematurity, the progression moves from abnormal retinal vascular growth to neovascular tissue that can pull on the retina. Stage 3 is the point when extraretinal (fibrovascular) neovascularization appears, extending from the optic nerve into the vitreous. That tissue can create traction on the retina, setting the stage for retinal detachment. As this traction increases, detachment progresses to Stage 4 (partial) and then Stage 5 (total). So Stage 3 is the critical point where neovascularization has progressed enough to threaten detachment, making it the best answer for when this process becomes severe enough to potentially lead to full detachment.