Combined oral propranolol with intralesional injection of triamcinolone acetonide in treatment of infantile periocular hemangiomas

• Main Authors: Alsmman AH, Mounir A
• Format: Article
• Language: English
• Published: Dove Medical Press 2017-12-01
• Series: Clinical Ophthalmology
• Subjects: infantile periocular haemangioma; oral propranolol; intralesional injection; tri-amcinolone acetonide
• Online Access: https://www.dovepress.com/combined-oral-propranolol-with-intralesional-injection-of-triamcinolon-peer-reviewed-article-OPTH

Alahmady H Alsmman, Amr Mounir Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt Aim: To evaluate the clinical effectiveness of combined oral propranolol with intralesional injection of triamcinolone acetonide in the treatment of infantile periorbital capillary hemangioma.Patients and Methods: This prospective interventional study included children diagnosed with periocular infantile hemangiomas in the proliferative phase with vision-threatening lesions. The children presented to the oculoplastic unit in Sohag University Hospital in the period between January 2016 and February 2017 and were treated with a combined intralesional injection of triamcinolone acetonide with oral propranolol, with a follow-up period of 6 months. Treatment response was evaluated according to the size of the tumor (horizontal diameter); additionally, complications of both treatment methods were recorded.Results: This study included 33 infants: 21 females (64%) and 12 males (36%). The mean age at the time of injection was 4.9±2.6 months. The study included three modes of treatment response: regression of the tumor, 28 patients (85%); stabilization, three patients (9%); and failure, two patients (6%), which necessitated repeated intralesional injection of triamcinolone but with minimal response. Regarding complications, only one patient reported with subconjunctival hemorrhage during intralesional injection of steroids; there were no recorded cases of hypotension, bradycardia, or hypoglycemia during the course of oral propranolol treatment. After the end of the follow-up period, there were no reported cases of recurrent increase in the size of the regressed group of infantile hemangiomas with stable tumor size.Conclusion: Combined oral propranolol with intralesional injection of triamcinolone acetonide is the effective method of treatment for infantile periorbital capillary hemangioma with minimal adverse effects. Keywords: infantile periocular hemangioma, oral propranolol, intralesional injection, triamcinolone acetonide