Reduction in astigmatism using propranolol as first-line therapy for periocular capillary hemangioma

To examine the shift in astigmatic error following the use of oral propranolol as first-line treatment for periocular capillary hemangioma.

Retrospective observational study.

study population: Three healthy infants (1 male) clinically diagnosed with periocular capillary hemangioma. Cycloplegic refraction measurements were obtained at presentation. After a comprehensive clinical evaluation, oral propranolol therapy was starting with a loading dose and titrated up to 2 mg/kg/day under monitoring of heart rate, blood pressure, and blood glucose alterations. Clinical follow-up and repeating cycloplegic refraction measurements were undertaken at the 1-week and 1- and 3-month follow-up visits.

Oral propranolol therapy for infants diagnosed with periocular capillary hemangioma.

Astigmatic refractive errors before and after propranolol treatment.

The infants' mean age at the initiation of propranolol therapy was 6.3 months (range: 3.0-8.0 months). A rapid therapeutic effect was noticed in all cases, including a major change in lesion size and color. No complications were recorded during or following treatment. The mean astigmatic error decreased from 2.83 diopters before propranolol treatment to 1.33 diopters after 1 month of treatment. The drug was well tolerated by all 3 patients and no side effects were noted.

Infants can benefit from a rapid, meaningful reduction in periocular capillary hemangioma-induced astigmatism following oral propranolol treatment. Propranolol seems to be an effective and safe drug, which can be used as a steroid-sparing first-line treatment modality in this patient population.