Stage 4 ROP is associated with which finding?

• A. Partial retinal detachment
• B. Neovascularization extending into the vitreous
• C. Retinal detachment (complete)
• D. Retinal hemorrhage

Answer: (A)

Stage 4 ROP represents a tractional change where fibrovascular tissue pulls on the immature retina, creating a partial detachment. The retina remains attached in some areas, but a portion is detached, distinguishing it from a total detachment seen in the most advanced stage. Stage 4 is often described with subcategories: 4A detachment not involving the fovea and 4B detachment involving the fovea, which influences prognosis. Neovascularization extending into the vitreous is the hallmark of Stage 3, not Stage 4, and a complete retinal detachment corresponds to the more advanced Stage 5. Retinal hemorrhage isn’t the defining feature of Stage 4.