Treatment of Periocular Infantile Hemangiomas with Propranolol: Case Series of 18 Children
| Autor: | Rosanne Superstein, Ariane Milet, Julie Powell, Nicole Fallaha, François Codère, Line Chevrette, Rola Al Dhaybi, Patrick Hamel, Josée Dubois, Afshin Hatami, Catherine McCuaig, Luis H. Ospina |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Vasodilator Agents medicine.medical_treatment Administration Oral Propranolol Antiarrhythmic agent Astigmatism Eyelid Neoplasms Hemangioma Lesion Occlusion Humans Medicine Hemangioma Capillary Ultrasonography Doppler Color Retrospective Studies Dose-Response Relationship Drug business.industry Vascular disease Infant medicine.disease Magnetic Resonance Imaging eye diseases Surgery Ophthalmology Treatment Outcome medicine.anatomical_structure Female Eyelid Neoplasm Recurrence Local medicine.symptom business Follow-Up Studies medicine.drug |
| Zdroj: | Ophthalmology. 118:1184-1188 |
| ISSN: | 0161-6420 |
| DOI: | 10.1016/j.ophtha.2010.10.031 |
| Popis: | Purpose To study the efficacy of propranolol in the treatment of periocular infantile hemangiomas (IHs). Design Retrospective interventional case series. Participants Eighteen children presenting periocular IH with occlusion of the pupil, anisometropic astigmatism, proliferating eyelid IH, or cosmetically disfiguring periocular IH. Methods All patients received treatment with propranolol started at 0.5 mg/kg/day with an incremental increase by 0.5 mg/kg/day every 4 days, up to a maximum of 2 to 3 mg/kg/day. Complete eye examinations and serial photographs were obtained before, during, and after treatment. Doppler ultrasound and magnetic resonance imaging performed pre- and post-treatment were compared when available. Main Outcome Measures Evolution of the treated IH was evaluated with respect to astigmatism, amblyopia, and size of the lesion. Results The IH size decreased in 17 of 18 patients. We noted a greater reduction when treatment was administered during the proliferative phase of growth of IHs. At the conclusion of treatment, none of our patients had amblyopia. The mean value of amblyogenic astigmatism (n = 7) decreased from 2.71 diopters (D) pretreatment to 1.03 D post-treatment. On radiology, 8 patients had significant regression of the lesion size of their IH and 1 patient had a limited progression. Propranolol had to be temporarily discontinued in only 1 patient because of symptomatic hypotension. Conclusions Propranolol seems to be an effective modality of treatment for periocular IH. It seems to be most efficacious when initiated in the proliferative phase of IH but may be beneficial even in the later stage. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article. |
| Databáze: | OpenAIRE |
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