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Effect of oral propranolol on periocular Capillary Hemangiomas of Infancy
Kirthi Koka1, Bipasha Mukherjee1, Sumita Agarkar2
1Orbit, Oculoplasty, Reconstructive & Aesthetic Services, Sankara Nethralaya, Medical Research Foundation, Chennai, India.
Insights
Oral propranolol effectively treats infantile periocular capillary hemangiomas (CHI). This study found the medication safe and well-tolerated in infants, with no adverse reactions or recurrence observed.
Area of Science:
- Ophthalmology
- Pediatric Dermatology
- Pharmacology
Background:
- Periocular capillary hemangiomas (CHI) are common benign vascular tumors in infants.
- Management of CHI can be challenging, requiring safe and effective therapeutic options.
- Oral propranolol has emerged as a promising treatment modality.
Purpose of the Study:
- To evaluate the safety and efficacy of oral propranolol for treating periocular capillary hemangiomas in infants.
- To assess treatment outcomes, including lesion size reduction and adverse effects.
Main Methods:
- Retrospective review of 21 infants with periocular CHI treated with oral propranolol.
- Dose titration of propranolol from 0.2-1 mg/kg to 2 mg/kg body weight over 48 hours if tolerated.
- Clinical assessment and radiographic imaging to evaluate treatment response and monitor for adverse events.
Main Results:
- All 21 infants showed a reduction in lesion size.
- The most common presentations were lid mass (80%) and proptosis (33%).
- No adverse reactions or recurrence of CHI were observed after propranolol cessation.
Conclusions:
- Oral propranolol is a highly effective and safe treatment for periocular capillary hemangiomas in infants.
- The medication demonstrates a favorable safety profile with no reported adverse effects or recurrence in this cohort.
- Propranolol offers a reliable therapeutic option for managing infantile periocular CHI.
Background:
To assess the safety and efficacy of oral propranolol in the management of periocular Capillary Hemangiomas of Infancy (CHI).
Methods:
Medical records of 21 infants diagnosed with periocular capillary hemangioma during a period of 5 years from 2009 to 2014 were retrospectively reviewed. The data collected included demographic details, clinical features and details of imaging studies and response to the therapy. All patients received oral propranolol under the supervision of a pediatrician. The initial dose was 0.2-1 mg/kg body weight, which was increased to 2 mg/kg body weight (3 divided doses) in 48 h if there was no adverse reaction to the initial dose. The response to the treatment was assessed clinically as well as by radiographic imaging. Photographic documentation was done periodically.
Results:
Out of 21 patients, 18 were females and remaining three were males. The median age at the time of presentation was 4 months. The most common presenting feature was lid mass (n = 17, 80%) followed by proptosis (n = 7, 33%). Reddish discoloration of face was seen in 2 (1%) patients. All patients showed reduction in the size of the lesion. None of the patients included in this study had any adverse reaction to propranolol or recurrence following cessation of the therapy.
Conclusion:
Oral propranolol is highly effective and safe in the treatment of periocular capillary hemangiomas in infants.
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