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Abstract
Purpose
To report the clinical results of systemic propranolol for infantile periorbital hemangiomas.
Methods
A retrospective analysis was performed on 11 patients who were treated with beta-blockers for cosmetic purposes or for those with an invalid visual axis from January 2010 to June 2017. A beta receptor blocker (propranolol) was administered at a dose of 2 mg/kg/day. The size of the lesion was analyzed using Image J software, version 1.47 (National Institutes of Health, Bethesda, MD, USA) at 1–2 months until the drug was discontinued after the initial treatment and discharge. We observed the occurrence of side effects such as hypoglycemia, nausea, and vomiting due to drug use.
Results
Of the 11 patients, 9 (82%) were female and 2 (18%) were male. The location of the capillary hemangioma was in the upper eyelid of eight eyes (72.7%) and in the lower eyelid of three eyes (27.3%). The mean duration of treatment was 6.2 months and the mean follow-up period was 8.3 months. In 11 patients (100%), the lesion size was reduced. A temporary allergic response was seen in one patient, but no adverse side effects were seen that involved life-threatening effects.
Conclusions
Infantile hemangiomas may cause cosmetic problems and amblyopia when invading the visual axis, which may require active treatment. Oral beta-blocker therapy for infantile hemangiomas of the orbit was safe for months or longer, with adequate treatment and with little to no adverse effects.
References
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Figure 1.
Photographs of Image J program. The color image was segmented from the image, the green channel was extracted, and then the center filter was applied. (A) The size of the cornea was set to 1 cm, and the size of the tumor was analyzed based on the corneal size for each image. (B) The lesion of a red color of hemangioma distinct from the normal skin was selected as the region of interest. (C, D) The size of the lesion was represented by the change of the number of black pixels in the binarized image and the degree of change of the capillary hemangioma was evaluated by measuring the absolute pixel value.
Figure 2.
Photographs of 3 month – old infant with an upper eyelid capillary hemangioma causing ptosis. (Left) pretreatment (A-C). (Right) After 10 months of propranolol treatment, there was regression of the lesion (D, E).
Figure 3.
Photographs of an infant 3 months of age with an upper eyelid infantile capillary hemangioma. (Left) At the first visit. (A, B) (Right) After 9 months of propranolol treatment, there was regression but eyelid swelling remained (C, D).
Table 1.
Details of patients treated with propranolol in periorbital capillary hemangioma
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