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Oral propranolol for treatment of periocular infantile hemangiomas.
Arch Ophthalmol. 2011 Jul; 129(7):899-903.AO

Abstract

OBJECTIVE

To evaluate the efficacy and adverse effects of oral propranolol for treatment of periocular infantile hemangioma.

METHODS

Participants were treated with oral propranolol 3 times daily, with outpatient monitoring of adverse effects. The starting dosage was 0.5 mg/kg/d for 1 week, then 1 mg/kg/d for the following week, then 2 mg/kg/d for the remaining duration of treatment. Serial examinations and external photography documented the size of the hemangiomas. Complete ophthalmic examinations included assessing for amblyopia with cycloplegic refraction and visual diagnostic testing. Amblyopia was treated with part-time occlusion therapy.

RESULTS

Nineteen periocular hemangiomas from 17 children (71% girls) were studied. The median age at the start of treatment was 4.5 months (interquartile range, 2.2-5.6 months). The median treatment duration was 6.8 months (interquartile range, 4.1-7.2 months). Treatment with oral propranolol reduced the size of all hemangiomas. Median change in the surface area was 61% (interquartile range, 32%-64%) of the original size. Mild rebound growth that did not necessitate retreatment was found in 2 patients (12%). One patient (6%) experienced a benign episode of bradycardia. Seven patients (41%) had amblyopia.

CONCLUSIONS

Oral propranolol for treatment of infantile hemangiomas was effective in all patients, with 33% reduction in astigmatism and 39% reduction in surface area. Vision equalized in all but 1 child, who receives ongoing amblyopia therapy. Our results suggest that early treatment with propranolol is remarkably effective in treating and preventing loss of visual acuity associated with periocular infantile hemangiomas.

Authors+Show Affiliations

Department of Ophthalmology, University of Missouri-Columbia, Columbia, MO 65212, USA. missoit@health.missouri.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21402978

Citation

Missoi, Tara G., et al. "Oral Propranolol for Treatment of Periocular Infantile Hemangiomas." Archives of Ophthalmology (Chicago, Ill. : 1960), vol. 129, no. 7, 2011, pp. 899-903.
Missoi TG, Lueder GT, Gilbertson K, et al. Oral propranolol for treatment of periocular infantile hemangiomas. Arch Ophthalmol. 2011;129(7):899-903.
Missoi, T. G., Lueder, G. T., Gilbertson, K., & Bayliss, S. J. (2011). Oral propranolol for treatment of periocular infantile hemangiomas. Archives of Ophthalmology (Chicago, Ill. : 1960), 129(7), 899-903. https://doi.org/10.1001/archophthalmol.2011.40
Missoi TG, et al. Oral Propranolol for Treatment of Periocular Infantile Hemangiomas. Arch Ophthalmol. 2011;129(7):899-903. PubMed PMID: 21402978.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oral propranolol for treatment of periocular infantile hemangiomas. AU - Missoi,Tara G, AU - Lueder,Gregg T, AU - Gilbertson,Kenneth, AU - Bayliss,Susan J, Y1 - 2011/03/14/ PY - 2011/3/16/entrez PY - 2011/3/16/pubmed PY - 2011/9/2/medline SP - 899 EP - 903 JF - Archives of ophthalmology (Chicago, Ill. : 1960) JO - Arch. Ophthalmol. VL - 129 IS - 7 N2 - OBJECTIVE: To evaluate the efficacy and adverse effects of oral propranolol for treatment of periocular infantile hemangioma. METHODS: Participants were treated with oral propranolol 3 times daily, with outpatient monitoring of adverse effects. The starting dosage was 0.5 mg/kg/d for 1 week, then 1 mg/kg/d for the following week, then 2 mg/kg/d for the remaining duration of treatment. Serial examinations and external photography documented the size of the hemangiomas. Complete ophthalmic examinations included assessing for amblyopia with cycloplegic refraction and visual diagnostic testing. Amblyopia was treated with part-time occlusion therapy. RESULTS: Nineteen periocular hemangiomas from 17 children (71% girls) were studied. The median age at the start of treatment was 4.5 months (interquartile range, 2.2-5.6 months). The median treatment duration was 6.8 months (interquartile range, 4.1-7.2 months). Treatment with oral propranolol reduced the size of all hemangiomas. Median change in the surface area was 61% (interquartile range, 32%-64%) of the original size. Mild rebound growth that did not necessitate retreatment was found in 2 patients (12%). One patient (6%) experienced a benign episode of bradycardia. Seven patients (41%) had amblyopia. CONCLUSIONS: Oral propranolol for treatment of infantile hemangiomas was effective in all patients, with 33% reduction in astigmatism and 39% reduction in surface area. Vision equalized in all but 1 child, who receives ongoing amblyopia therapy. Our results suggest that early treatment with propranolol is remarkably effective in treating and preventing loss of visual acuity associated with periocular infantile hemangiomas. SN - 1538-3601 UR - https://www.unboundmedicine.com/medline/citation/21402978/Oral_propranolol_for_treatment_of_periocular_infantile_hemangiomas_ L2 - https://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/archophthalmol.2011.40 DB - PRIME DP - Unbound Medicine ER -