Long term outcomes of transcutaneous non-image guided bleomycin sclerotherapy in orbital/adnexal lymphatic malformations: a protocol-based management in 69 eyes.

Autor: Dave TV; Ophthalmic Plastic Surgery Service, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, India. tvdeye@gmail.com.; Operation Eyesight Universal Institute for Eye Cancer, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, India. tvdeye@gmail.com., Madhuri BK; Ophthalmic Plastic and Facial Aesthetic, Orbit and Ocular Oncology Service, Kode Venkatadri Chowdary Campus, L V Prasad Eye Institute, Vijayawada, Andhra Pradesh, India., Laghmisetty S; Ophthalmic Plastic Surgery Service, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, India.; Operation Eyesight Universal Institute for Eye Cancer, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, India., Tripathy D; Ophthalmic Plastics, Orbit and Ocular Oncology, Mithu Tulsi Chanrai Campus, L V Prasad Eye Institute, Bhubaneswar, Odisha, India., Kaliki S; Operation Eyesight Universal Institute for Eye Cancer, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, India., Rath S; Ophthalmic Plastics, Orbit and Ocular Oncology, Mithu Tulsi Chanrai Campus, L V Prasad Eye Institute, Bhubaneswar, Odisha, India., Mohapatra S; Ophthalmic Plastics, Orbit and Ocular Oncology, Mithu Tulsi Chanrai Campus, L V Prasad Eye Institute, Bhubaneswar, Odisha, India., Desai A; Ophthalmic Plastic and Facial Aesthetic, Orbit and Ocular Oncology Service, GMR Varalakshmi Campus, L V Prasad Eye Institute, Visakhapatnam, Andhra Pradesh, India., Kapoor AG; Ophthalmic Plastic and Facial Aesthetic, Orbit and Ocular Oncology Service, Kode Venkatadri Chowdary Campus, L V Prasad Eye Institute, Vijayawada, Andhra Pradesh, India.
Jazyk: angličtina
Zdroj: Eye (London, England) [Eye (Lond)] 2022 Apr; Vol. 36 (4), pp. 789-799. Date of Electronic Publication: 2021 Apr 20.
DOI: 10.1038/s41433-021-01527-9
Abstrakt: Objectives: To study the efficacy and the long-term outcomes of treating micro and macrocystic orbital and/or adnexal lymphatic malformations (OA-LM) with protocol-based bleomycin sclerotherapy.
Methods: A retrospective interventional study of 69 eyes having OA-LM treated with non-image guided transcutaneous or transconjunctival bleomycin sclerotherapy (1IU/ml aqueous solution) between December 2014 and December 2018. Based on clinical regression, the outcomes were classified as excellent, good, fair and poor.
Results: The mean age at presentation was 20 ± 16 years (median 16; range 1 month to 70 years). The orbital-palpebral variant was the most common presentation, seen in 29 patients (42%). Microcystic morphology was seen in 34(49%), macrocystic in 22 (32%) and mixed cyst in 13 (19%) patients. Mean units of bleomycin injected per patient were 9 ± 8 IU (median 5.5 IU, range 1-38 IU). Mean number of treatment sessions required were 2 ± 1 (median 2, range 1-6). The response was excellent in 43 (62%), good in 12 (17%), fair in 9 (13%) and poor in 5 (7%) patients. These responses were comparable across the morphological subgroups (p = 0.24, chi-square test). Adverse reactions noted were inflammation in 11 eyes (16%) and peri-ocular pigmentation in 15 (22%). There was a sustained tumour regression over a mean follow-up duration of 3.5 years (median 3; range 1.5-5 years).
Conclusions: Seventy-nine percent of eyes with OA-LM showed a good outcome with transcutaneous and/or transconjunctival non-image guided bleomycin sclerotherapy with no serious adverse events. The results were promising over long-term follow-up.
(© 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)
Databáze: MEDLINE
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