A rare case of aggressive posterior retinopathy of prematurity presenting with exudative retinal detachment.

Aggressive posterior retinopathy of prematurity (APROP) is the most severe form of retinopathy of prematurity (ROP), with rapid progression to tractional retinal detachment. Exudative retinal detachment (ERD) has rarely been described as a primary presentation in ROP. We present a case of unlasered zone 1 APROP in a 34-week infant presenting with bilateral ERD, which was treated with intravitreal ranibizumab. After injection, the left eye developed acute endophthalmitis, which was managed by intravitreal antibiotic therapy and early vitrectomy. Subsequent laser photocoagulation of the avascular areas resulted in regression of ROP. This case highlights the role of intravitreal anti-vascular endothelial growth factor in treating ERD in APROP and the need for close observation for endophthalmitis after injection.