Treatment of Periorbital Infantile Capillary Hemangioma with Propranolol

Purpose: To report the clinical results of systemic propranolol for infantile periorbital hemangiomas. Methods: A retrospective analysis was performed on 11 patients who were treated with beta-blockers for cosmetic purposes or for those with an invalid visual axis from January 2010 to June 2017. A beta receptor blocker (propranolol) was administered at a dose of 2 mg/kg/day. The size of the lesion was analyzed using Image J software, version 1.47 (National Institutes of Health, Bethesda, MD, USA) at 1–2 months until the drug was discontinued after the initial treatment and discharge. We observed the occurrence of side effects such as hypoglycemia, nausea, and vomiting due to drug use. Results: Of the 11 patients, 9 (82%) were female and 2 (18%) were male. The location of the capillary hemangioma was in the upper eyelid of eight eyes (72.7%) and in the lower eyelid of three eyes (27.3%). The mean duration of treatment was 6.2 months and the mean follow-up period was 8.3 months. In 11 patients (100%), the lesion size was reduced. A temporary allergic response was seen in one patient, but no adverse side effects were seen that involved life-threatening effects. Conclusions: Infantile hemangiomas may cause cosmetic problems and amblyopia when invading the visual axis, which may require active treatment. Oral beta-blocker therapy for infantile hemangiomas of the orbit was safe for months or longer, with adequate treatment and with little to no adverse effects. J Korean Ophthalmol Soc 2018;59(5):397-402