Effect of Oral Propranolol on Periocular Infantile Capillary Hemangioma: Outcomes Based on Extent of Involvement
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Kavya M Bejjanki1, Kahkashan Akhtar1, Arushi P Gupta1
1Ocular Oncology Serices, The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India.
Insights
Oral propranolol effectively treats periocular infantile capillary hemangioma (CHI). Segmental and preseptal CHI showed better response to propranolol treatment than focal and postseptal types.
Area of Science:
- Ophthalmology
- Dermatology
- Pediatrics
Background:
- Periocular infantile capillary hemangioma (CHI) presents a therapeutic challenge.
- Understanding lesion characteristics based on embryological facial placodes is crucial for treatment efficacy.
Purpose of the Study:
- To assess the effectiveness of oral propranolol for periocular CHI.
- To correlate treatment outcomes with lesion classification based on embryological facial placodes and anatomical location.
Main Methods:
- Retrospective analysis of 27 patients with periocular CHI treated with oral propranolol.
- Classification of lesions as focal or segmental based on embryological facial placodes.
- Categorization of lesions as preseptal, postseptal, or combined based on anatomical involvement.
Main Results:
- Overall mean resolution of periocular CHI was 78% with oral propranolol over a mean follow-up of 16 months.
- Segmental lesions (92% resolution) and preseptal components (94% resolution) demonstrated superior response compared to focal lesions (69% resolution) and postseptal components (74% resolution).
- Four patients (15%) experienced lesion flare-up after propranolol tapering.
Conclusions:
- Oral propranolol is an effective treatment for periocular infantile capillary hemangioma.
- Lesion type significantly influences treatment response, with segmental and preseptal CHI responding better than focal and postseptal CHI.
Purpose:
To evaluate the efficacy of oral propranolol in the treatment of periocular infantile capillary hemangioma (CHI) based on the involvement of embryological facial placodes and their extent of anatomical involvement.
Methods:
Retrospective study of 27 patients.
Results:
The mean age at the presentation of periocular CHI was 4 months (median, 3 months; range, <1-14 months). There were 11 (41%) males and 16 (59%) females. Based on embryological facial placodes, the involvement was focal in 16 (59%) cases and segmental in 11 (41%) cases. Based on the anatomical distribution, the lesions were preseptal in 4 (15%), postseptal in 13 (48%), and combined in 10 (37%) cases. The duration of use of oral propranolol was 10 months (median, 10 months; range, 4-16 months). Overall, the mean % resolution of periocular CHI was 78% (median, 90%; range, 20%-100%). The mean percentage resolution of focal lesions was 69% (median, 83%; range, 20%-100%), and segmental lesions were 92% (median, 95%; range, 70%-100%). The mean percentage resolution of preseptal component of lesions was 94% (median, 95%; range, 80%-100%) and postseptal component was 74% (median, 85%; range, 20%-100%) over a mean follow-up period of 16 months (median, 15 months; range, 4-37 months). Four (15%) patients exhibited flare-up of lesion after tapering oral propranolol.
Conclusion:
Oral propranolol is effective in the treatment of periocular CHI. Segmental and preseptal lesions respond better to the treatment compared to focal and postseptal lesions.
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