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Relationship of infantile periocular hemangioma depth to growth and regression pattern
Katya Tambe1, Vineeta Munshi, Clare Dewsbery
1Birmingham Children's Hospital, Department of Ophthalmology, Steelhouse Lane, Birmingham, United Kingdom.
Insights
Deeper infantile periocular hemangiomas show later onset and prolonged growth compared to superficial strawberry nevi. Hemangioma depth predicts resolution speed, aiding prognosis and treatment planning.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Dermatology
Background:
- Infantile periocular hemangiomas typically grow rapidly in the first year, then slowly resolve.
- Treatment is crucial when vision is threatened, often continuing through the growth phase.
Purpose of the Study:
- To identify clinical characteristics predicting growth and regression patterns in periocular hemangiomas.
- To improve prognostic assessment and treatment strategies for these conditions.
Main Methods:
- Retrospective review of medical records and photographs of 42 infants with periocular hemangiomas.
- Data collected included age, growth pattern, size, location, amblyopia, and refractive status.
- Follow-up averaged 24 months, ranging from 6 months to 5 years.
Main Results:
- One-third were superficial (strawberry nevi), one-third subcutaneous, and the rest mixed or orbital.
- Superficial hemangiomas exhibited different growth patterns than deeper (subcutaneous, orbital) types.
- Deeper hemangiomas demonstrated a more extended growth period.
Conclusions:
- Periocular hemangiomas with deep components present later and grow longer than superficial strawberry nevi.
- The clinical depth of a hemangioma is a key predictor of how quickly it will resolve.
- This insight aids in predicting outcomes and tailoring treatment for infantile periocular hemangiomas.
Purpose:
Most infantile periocular hemangiomas undergo rapid growth in the first year of life, followed by gradual resolution over years. Treatment is indicated if vision is compromised and is usually continued through the growth phase. The objective of this study was to determine which clinical characteristics might aid in the prediction of growth and/or regression patterns of periocular hemangiomas.
Methods:
Retrospective review of medical records and photographs of children with periocular hemangiomas presenting to a UK pediatric eye unit over a 7-year period. Age at presentation, growth pattern, size, location, amblyopia, and refractive status were documented.
Results:
Forty-two infants with periocular hemangiomas were evaluated between 2000 and 2007, with a mean follow-up of 24 months (range, 6 months to 5 years). One-third (n=14, 33%) of the hemangiomas were superficial (strawberry nevi); one-third were subcutaneous (n=13, 31%), and the remainder were mixed (n=8, 19%) and orbital (n=7, 17%). There was a marked difference between the growth patterns of superficial (strawberry nevi) and deeper hemangiomas (orbital and subcutaneous), with a more prolonged period of growth noted in the deeper hemangiomas.
Conclusions:
Periocular hemangiomas with a deep component tend to have a later onset and prolonged period of growth compared to strawberry nevi. Clinically evident depth of the hemangioma appears to be a valuable predictor of rapidity of resolution. This finding may be useful in assessing prognosis and planning treatment of infantile periocular hemangiomas.
