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Published on: August 6, 2020
Prevalence and clinical features of orbital vascular anomalies in children
Laura A Torrado-Cobian1, Gregory J Griepentrog2, David O Hodge3
1Mayo Clinic Department of Ophthalmology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
Insights
Orbital vascular anomalies (OVAs) in children are most commonly capillary hemangiomas and lymphatic malformations. Early diagnosis and management are crucial, as amblyopia and strabismus are frequent complications.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Vascular Biology
Background:
- Orbital vascular anomalies (OVAs) are a diverse group of conditions affecting children.
- Understanding their prevalence, characteristics, and outcomes is vital for effective clinical management.
Purpose of the Study:
- To determine the prevalence, clinical features, and long-term outcomes of pediatric orbital vascular anomalies.
- To analyze a 50-year cohort of children diagnosed with OVAs.
Main Methods:
- Retrospective review of medical records for patients under 19 years old diagnosed with OVAs.
- Data collected from January 1, 1966, to December 31, 2015, at Mayo Clinic, Rochester, Minnesota.
Main Results:
- 109 children diagnosed with OVAs; birth prevalence of 1 in 4,305 live births.
- Most common diagnoses: capillary hemangiomas (49.5%) and low-flow lymphatic malformations (46%).
- Common symptoms: proptosis (73.4%), skin color abnormalities (41.3%); amblyopia/strabismus occurred in 43.4%.
Conclusions:
- Capillary hemangiomas and lymphatic malformations are the predominant pediatric OVAs.
- Amblyopia and strabismus are significant sequelae, underscoring the need for prompt diagnosis and intervention.
Purpose:
To report the prevalence, clinical characteristics, and natural history of orbital vascular anomalies diagnosed among children over a 50-year period.
Methods:
The medical records of all patients <19 years diagnosed with any form of an orbital vascular anomaly (OVA) at Mayo Clinic, Rochester, Minnesota from January 1 1966, through December 31 2015, were retrospectively reviewed.
Results:
A total of 109 children were diagnosed with OVA during the 50-year period, of which 24 were from Olmsted County, MN, yielding a birth prevalence of 1 in 4,305 live births. The median age at diagnosis for the 109 patients was 1.2 years (range, 0-17.9 years) and 67 (61.5%) were female. Common presenting symptoms included proptosis in 80 (73.4%) patients, abnormalities in skin color in 45 (41.3%) patients, and pain in 18 (16.5%) patients. There were 55 (50.5%) vascular malformations [50 (91%) low-flow lymphatic malformations, 3 (5.5%) high-flow arteriovenous malformations, and 2 (3.5%) low-flow venous malformations] and 54 (49.5%) vascular tumors [53 (98%) capillary hemangiomas and 1 (2%) kaposiform hemangioendothelioma]. During a mean follow-up of 5.95 years (range 0-27.7 years), amblyopia and/or strabismus were diagnosed in 46 (43.4%) patients.
Conclusions:
Capillary hemangiomas and low-flow lymphatic malformations comprise most of the orbital vascular anomalies in this cohort of children. Amblyopia and strabismus are common sequelae, highlighting the importance of early diagnosis and appropriate management.
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