Related Experiment Video
Updated: May 2, 2026
A Neonatal Rodent Model of Retroorbital Vein Injection
Published on: February 23, 2024
Propranolol as first-line treatment in orbital infantile haemangiomas: a case series
M Levitt1, A D Coumou, L Groeneveld
1Department of Ophthalmology .
Insights
Propranolol effectively treats orbital infantile hemangiomas (IHs), showing rapid tumor reduction and lesion regression. Magnetic Resonance Imaging (MRI) aids in diagnosis and monitoring treatment efficacy for these vascular tumors.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Radiology
Background:
- Orbital infantile hemangiomas (IHs) are benign vascular tumors that can cause vision-threatening complications.
- Early diagnosis and treatment are crucial to prevent amblyopia and other ocular morbidities.
Observation:
- A retrospective case series of 5 infants with orbital IH presenting with proptosis and risk of amblyopia.
- Magnetic Resonance Imaging (MRI) revealed characteristic IH lesion features including flow voids and contrast enhancement.
- Patients received propranolol, starting at 0.6 mg/kg/day and escalating to 2.7 mg/kg/day.
Findings:
- MRI demonstrated typical IH characteristics: flow voids, high contrast enhancement, specific T1W/T2W signals, and lobulated appearance.
- All 5 patients exhibited a rapid clinical response to propranolol, with significant tumor size reduction within 1-3 weeks.
- Complete lesion regression was observed by the end of the treatment course.
Implications:
- Propranolol is an effective and safe treatment for orbital IHs under controlled conditions.
- MRI is a valuable diagnostic tool for orbital IHs, aiding in treatment planning and response assessment.
- This study supports the dual role of propranolol as both a diagnostic aid and therapeutic agent for orbital IHs.
Purpose:
To highlight the importance of Magnetic Resonance Imaging (MRI) and the use of propranolol as both a final diagnostic tool and adequate treatment for orbital Infantile Haemangiomas (IHs).
Methods:
A retrospective study was conducted using a case series of 5 infants diagnosed with orbital IH. All patients presented with progressive unilateral proptosis and were at high risk of developing amblyopia, some had combined swelling of the eyelid, impaired eye movements or exposure keratopathy. Propranolol was administered in an initial dose of 0.6 mg/kg/day orally divided in three daily doses and increased in 4 days to 2.7 mg/kg/day. MRI was performed in all children.
Results:
Striking MR characteristics of an IH lesion were seen in each of our 5 cases, including the presence of flow voids, high contrast enhancement, hypo-intense T1W signal, iso- to hyper intense T2W signal, and lobulated appearance. All patients showed a quick clinical response to treatment, resulting in significant reduction in tumour size within a range of 1-3 weeks and almost complete regression of the lesion at the end of the treatment schedule.
Conclusions:
Our study adds another 5 cases to the growing body of reports confirming the efficacy and safety - under controlled circumstances - of propranolol therapy in orbital IH management, in which we highlight the use of propranolol as both a final diagnostic tool and as an adequate treatment.
More Related Videos
Related Concept Videos
01:27Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers
01:31Adrenergic Antagonists: ɑ and β-Receptor Blockers
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...