Propranolol as an effective treatment for inoperable periocular haemangiomas in children

Lidia Babiak-Choroszczak, Kaja Giżewska-Kacprzak, Lidia Puchalska-Niedbał, Anna Walecka, Elżbieta Gawrych


Introduction: Infantile haemangiomas located in the periocular region are a significant clinical problem. When untreated, they can lead to serious complications that can inhibit the proper development of vision. As they are often inaccessible surgically, a noninvasive eye-saving therapy is required. The aim of the study was to assess the effectiveness of propranolol treatment for inoperable periocular haemangiomas (PH) in children.

Material and methods: Seventeen children with haemangiomas of the upper and lower eyelid and internal eyelid angle were thoroughly examined. Lesions were seriously affecting movement of eyelids leading to ptosis in most of cases, but anisometric astigmatism and exophtalmia were also diagnosed. Patients were carefully qualiϐied for propranolol treatment and were re -evaluated when therapy was completed.

Results: In all of the described cases brightening and softening of the lesion were observed from the ϐirst days of therapy. Ninety percent of patients showed signs of complete involution. In 5 cases a mild discolouration or skin enhancement persisted. All children presented signiϐicant functional improvement. An 86% reduction of astigmatism was found in cases that were diagnosed initially.

Conclusions: In conclusion, early diagnosis and introduction of propranolol for PH reduce the risk of complications that pose a threat to eye function. Measurement of astigmatism reduction may be a useful tool to establish a proper moment to cease the therapy. Propranolol is the ϐirst choice treatment option in PH based on its effectiveness, speed of action, and low rate of side effects.


infantile haemangioma, periocular haemangioma, astigmatism, propranolol

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