Oral propranolol for the treatment of periorbital infantile hemangioma: A preliminary report from Oman

Abstract

Purpose:To investigate the efficacy and safety of oral propranolol in the management of periorbital infantile hemangioma in four subjects.Materials and Methods:Consecutive patients who presented with periorbital capillary hemangioma with vision-threatening lesions were prospectively enrolled in this study between January 2009 and October 2010. All subjects underwent treatment with 2 mg/kg/day oral propranolol. All subjects underwent ocular, systemic, and radiologic evaluations before treatment and at periodic intervals after starting therapy. Side effects from therapy were also evaluated.Results:Four subjects, between 3 months and 19 months of age, with periorbital hemangioma were enrolled in this study. Two subjects had been previously treated with oral corticosteroids with unsatisfactory response. All subjects had severe ptosis, with the potential for deprivation amblyopia. Three subjects had orbital involvement. After hospital admission, oral propranolol was initiated in all subjects under monitoring by a pediatric cardiologist. Subsequent therapy was performed with periodic out-patient monitoring. All subjects had excellent response to treatment, with regression of periorbital and orbital hemangioma. There were no side effects from therapy.Conclusions:Oral propranolol for periorbital hemangioma was effective in all the four subjects. Oral propranolol may be appropriate for patients who are nonresponsive to intralesional or systemic steroids. In patients with significant orbital involvement and lesions causing vision-threatening complications, oral propranolol can be the primary therapy.

Treatment outcomes of oral propranolol in the treatment of periocular infantile capillary hemangioma and factors predictive of recurrence and incomplete resolution: A multi-centric study

“…The rate of resolution is variable in several studies, partial resolution (60%–85%) being higher than complete resolution (25%–40%). [ 17 18 19 20 21 22 31 32 33 ] In our series, complete resolution was noted in 46.43% while >50% reduction in size was noted in 25%. 28.57% showed a reduction <50% of the original lesion.…”

“…Although there is significant literature on the role of propranolol and its related complications/side effects in IH affecting other parts of the body, the literature regarding periocular IH treated with OP is limited. [ 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 ] There is no definitive consensus regarding the duration of therapy as the rate of rebound growth of the lesion after stopping treatment has been reported to be 10%–30%. [ 27 28 29 ] Although the success of OP therapy is quite high, cases with no or poor response to OP after the initial few weeks have also been illustrated in the literature.…”