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Eyelid Thread-lifting Treatment for Periocular Infantile Hemangioma in an Extremely Premature Low-birth-weight Infant
Ayana Kurachi1, Mine Ozaki1, Aki Ihara1
1Department of Plastic, Reconstructive and Aesthetic Surgery, Kyorin University School of Medicine, Mitaka, Tokyo, Japan.
Insights
Periocular infantile hemangioma (IH) in premature infants can threaten vision. Topical steroid injection and eyelid thread-lifting successfully treated a case unresponsive to oral propranolol, preventing visual impairment.
Area of Science:
- Ophthalmology
- Neonatology
- Dermatology
Background:
- Periocular infantile hemangioma (IH) poses a risk of amblyopia due to visual field obstruction.
- Prompt treatment is crucial during an infant's sensitive visual development period.
- Oral propranolol is a common treatment, but its efficacy for vision-threatening IH, especially in preterm infants, is not fully established.
Observation:
- A case of periocular IH in an extremely premature, low-birth-weight infant (526g) is presented.
- The lesion did not respond to two weeks of oral propranolol treatment.
- The infant experienced significant visual field obstruction due to the hemangioma.
Findings:
- Topical steroid injection combined with eyelid thread-lifting management provided a successful treatment outcome.
- This combined approach rapidly resolved the vision-threatening condition.
- The infant achieved successful visual recovery without any long-term visual impairment.
Implications:
- This case highlights an effective alternative treatment strategy for severe periocular IH in extremely premature infants.
- It suggests that a multimodal approach may be superior to oral propranolol in specific critical cases.
- Further research into evidence-based treatments for IH in preterm infants is warranted.
Abstract:
Periocular infantile hemangioma (IH) sometimes hinders proper eye opening and limits the visual field. Even short-term deprivation of hemilateral vision may cause amblyopia in infants during the visually sensitive period and, thus, necessitates prompt treatment. Propranolol is a commonly known remedy for IH, though it may not act sufficiently to rapidly resolve a vision-threatening critical condition in an infant. Low birth weight is a significant risk factor for IH incidence. Despite the high incidence, evidence-based treatment for IH in preterm infants has not been established. This report describes periocular IH of an extremely premature low-birth-weight infant (body weight: 526 g) whose lesion showed no reduction after oral administration of propranolol for 2 weeks but was successfully treated by topical steroid injection and eyelid thread-lifting management, with no eventual visual impairment.
