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Simulate retinopathy of prematurity (ROP) — a vasoproliferative disorder of the developing preterm neonatal retina and the leading cause of preventable childhood blindness in middle- and high-income countries, affecting an estimated 14,000–16,000 premature infants per year in the United States alone. ROP arises from the disruption of normal centrifugal retinal vascularisation: in utero, retinal blood vessels grow outward from the optic disc toward the ora serrata, a process driven by physiological retinal hypoxia and VEGF (vascular endothelial growth factor) signalling. When an infant is born prematurely (typically <32 weeks gestational age, <1500 g birth weight) and exposed to supplemental oxygen therapy, relative hyperoxia suppresses VEGF expression, halting normal vascular development (Phase I — vaso-obliterative phase). As the metabolically active avascular retina matures and demands more oxygen, the resulting ischaemia triggers massive VEGF overexpression, driving pathological extraretinal neovascularisation at the junction between vascularised and avascular retina (Phase II — vasoproliferative phase). The International Classification of ROP (ICROP) defines disease by: zone (I — posterior pole within 2 disc diameters of macula; II — equator to nasal edge of zone I; III — remaining anterior crescent), stage (1 — demarcation line; 2 — ridge; 3 — ridge + extraretinal fibrovascular proliferation; 4 — partial retinal detachment; 5 — total retinal detachment), and the presence of plus disease (arteriolar tortuosity and venous dilatation in at least 2 quadrants of the posterior pole). Treatment: laser ablation of avascular retina and/or intravitreal anti-VEGF injection (ranibizumab, bevacizumab). Model three ROP severity categories with ΔE colour shift, CIE xy chromaticity, and image simulation.

Retinopathy of prematurity colour science simulation by Auric Artisan.

Base color
ROP severity category & settings
Retinal vascular / structural damage severity 50%
Image simulation
Upload JPG/PNG (max 1200 × 1200). See how a scene appears through mild ROP (Zone II/III, minimal retinal impact, possible myopia), threshold ROP with plus disease (macular oedema, neovascularisation glare, reduced contrast), or cicatricial ROP (dragged macula, tractional distortion, high myopia with central vision loss).
Research notes
ROP two-phase pathogenesis: Phase I (hyperoxia → vaso-obliteration, weeks 22–30 PMA): supplemental oxygen in NICU suppresses VEGF, halting retinal vascular growth and obliterating some existing immature vessels at the advancing vascular front. Phase II (ischaemia → vasoproliferation, weeks 31–44 PMA): the growing neural retina creates metabolic demand exceeding oxygen supply from the arrested vasculature → retinal ischaemia → HIF-1α up-regulation → massive VEGF/PDGF/IGF-1 overexpression → pathological neovascularisation at the vascularised/avascular border. Anti-VEGF therapy targets this Phase II vasoproliferative surge.
Swatches
Normal
HEX: — • RGB: — • xy: —
ROP affected
HEX: — • RGB: — • xy: —
ΔE (CIE76)
—
ΔE (CIEDE2000)
—
Deep preview
Normal
ROP (deep)
Chromaticity (CIE xy)
ROP retinal vascular chromaticity shift
D65 white point: 0.313, 0.329
Image simulation

ROP simulations model the visual consequences of VEGF-driven retinal vascular pathology in the sRGB colour space. Mild ROP (Zone II/III, Stage 1-2): minimal cone-mediated colour impact — primarily myopic defocus-driven contrast reduction modelling the high myopia of prematurity (average -3 to -6 dioptres) that develops in ~80% of infants with treated ROP. Threshold ROP (Zone I/II, Stage 3 + plus disease): models macular oedema and perimacular neovascularisation glare as combined luminance reduction + chroma desaturation + mild scatter effect. Cicatricial ROP (Stage 4-5): models the severe visual consequences of tractional retinal detachment and dragged macula — significant luminance loss, chroma destruction, and chromaticity convergence reflecting the distorted foveal architecture and photoreceptor loss from chronic retinal traction. ΔE2000 per Sharma et al. (2005). Not for clinical screening — ROP screening requires indirect ophthalmoscopy or wide-field retinal imaging (RetCam) per AAP screening guidelines.

Multi-condition comparison
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Compare mild ROP (spontaneous regression), threshold ROP (treatment-requiring neovascularisation + plus disease), and cicatricial ROP (tractional retinal detachment, dragged macula) visual impact.