Shabana Chaudhry, Intzar Hussain, Shahid Mehmood.
Treatment of Periocular Infantile Hemangiomas with Oral Propranolol.
Ophthalmol Update Jan ;12(4):257-61.

Purpose: To determine the efficacy and safety of early treatment with propranolol in infants aged less than 6 months affected by periocular infantile hemangioma. Design: Prospective interventional case series. Patients and Methods: Nine infants, 3 to 4 months of age, with periocular capillary hemangiomas with occlusion of the pupil, anisometropic astigmatism or proliferating eyelid infantile hemangioma (IH) and proptosis were treated with oral propranolol (Inderal, 20mg/5ml) 2.0 mg/kg per day divided in 2 doses. Propranolol was continued up to 1-6 months and tapered over 2-3 weeks. All infants were followed for 6- 8 months. Lesion size and evolution were assessed during the follow-up period with serial photographs before, during, and after treatment. Magnetic resonance imaging was performed pre- and post-treatment when possible. Main Outcome Measures: Evolution of the treated infantile hemangioma was evaluated with respect to astigmatism and size of the lesion. Results: Significant improvement was noted in 7/9 patients in the first 2 months of therapy with slow and continuous effect throughout the follow-up period. No serious complications were observed. Conclusions: Propranolol was found to be an effective modality of treatment for periocular IH. It appears to be a most efficacious when initiated in the proliferative phase of IH.

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