Propranolol for orbital hemangioma.

A 6-week-old girl was referred for management of a large left orbital and periorbital capillary hemangioma (Figure 1, Figure 2, Figure 3 and Figure 4; available at http://aaojournal.org). The neoplasm had been present since birth and getting progressively larger with resultant occlusive, anisometropic, and strabismic amblyopia of the left eye. She had received 1 intralesional steroid injection 2 weeks prior to presentation with no significant change. She also had 2 other cutaneous capillary hemangiomas on her scalp and abdomen (Fig 4; available at http:// aaojournal.org). She was treated with systemic oral steroids (1 mg/kg/day). At 2 weeks followup, the tumor had not responded, or slightly progressed. She was then treated on outpatient basis with propranolol 2 mg/kg/day; simultaneously, oral steroids were tapered off over the next 2 weeks. She showed dramatic improvement, starting days after the initiation of the propranolol (Fig 2; available at http://aaojournal.org). The propranolol was continued over 2 months, concurrent with amblyopia therapy. At 6-month follow-up, 3 months after discontinuation of propranolol, there has been no regrowth of the orbital neoplasm (Figure 3 and Figure 4; available at http://aaojournal.org). Of note, her other cutaneous lesions resolved completely after being on propranolol for a few weeks (Fig 4; available at http://aaojournal.org). There was no systemic complication from using propranolol. The speed of resolution after initiating propranolol supports the role of propranolol in this case. ! Permissions & Reprints !doi:10.1016/j.ophtha.2009.08.040 | How to Cite or Link Using DOI