Propranolol as First-Line Treatment in Orbital Infantile Haemangiomas: A Case Series

Abstract

Our study adds another 5 cases to the growing body of reports confirming the efficacy and safety - under controlled circumstances - of propranolol therapy in orbital IH management, in which we highlight the use of propranolol as both a final diagnostic tool and as an adequate treatment.

Effect of oral propranolol on periocular Capillary Hemangiomas of Infancy

“…All of these are potentially vision threatening in infants and require prompt intervention. 4,6,7 In our study six children had eyelid swelling leading to mechanical ptosis and obscuration of the visual axis. Seven children presented with significant proptosis and the remaining eight had periocular mass and skin discoloration causing cosmetic deformity.…”

“…Change in the color of the lesion and softening of the mass is observed due to vasoconstriction. 4,6,15 Nearly one third of our patients had visible improvement within a week.…”

Episcleral infantile hemangioma successfully treated with topical timolol

“…Both systemic or intralesional corticosteroids and surgery have been used with vision‐threatening complications and suboptimal results . Beta‐blockers have become the first‐line treatment for periorbital hemangiomas due to their efficacy and low adverse event profile . A single case of an episcleral hemangioma successfully treated with oral propanolol has been reported .…”

Beta Blockers in the Treatment of Periocular Infantile Hemangiomas: A Review

“…Since this discovery, many retrospective case series as well as a randomized clinical trial have evaluated the safety and efficacy of oral propranolol as first-line therapy for the treatment of periocular IH. [17][18][19][20][21][22][23][24][25][26] More recently, several case series have also evaluated topical beta blocker therapy with timolol for periocular IH with promising results. [27][28][29][30][31] Herein, we summarize the literature and treatment recommendations for the use of oral and topical beta blockers in periocular IH.…”