PURPOSE: To document that lacunar, atrophic lesions of the retinal pigment epithelium, previously reported as a complication of treatment, can result from the natural course of retinopathy of prematurity. METHODS: We reviewed photographs of patients diagnosed with retinopathy of prematurity at the Casey Eye Institute between 1979 and 1996. Lacunar atrophic lesions of the retinal pigment epithelium were correlated with the clinical records of the affected patients. RESULT: Three untreated eyes of three patients with retinopathy of prematurity had lacunar atrophic lesions of the retinal pigment epithelium. CONCLUSIONS: The spectrum of findings associated with untreated retinopathy of prematurity includes lacunar, atrophic lesions of the retinal pigment epithelium. These lesions are distinct from scars secondary to treatment and are possibly linked to macular dragging and exudative or serous retinal detachment.
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