Oral Propranolol in Treatment of Infantile Peri-Ocular and Orbital Capillary Hemangioma: A Prospective Study

Objectives: To evaluate the effect of oral propranolol in the treatment of infantile peri-orbital and/ or orbital capillary hemangioma. Methods: We conducted a prospective study at Prince Rashid Bin Al Hassan military hospital between 5 of August 2012 and 29 of January 2013. Eleven patients with peri-orbital and/or orbital capillary hemangiomas were included in this study. All patients underwent complete ophthalmic examination. Capillary hemangiomas were assessed, reporting their size, location, extension, and effect on the surrounding structures. Follow up duration ranged from two to six months. Results: The age of patients with peri-orbital and/ or orbital capillary hemangiomas ranged from three to 17 months with a mean of 7 ± 4.92 months. Male: female ratio was 1: 1.75. The upper eyelid was involved in seven (64%) cases, all of them had ptosis, three (43%) had dystopia, one (14%) had imbrication, and one (14%) had squint. The lower eyelid was involved in two (18%) cases; one of them was associated with lower lip capillary hemangioma. Orbital involvement was seen in eight (73%) cases, six (75%) of them were associated with upper eyelid involvement and two (25%) with lower eyelid involvement. Concurrent extra-ocular localization of hemangiomas was present in five (45%) cases (one in lip, one in tongue, 2 in forehead, and one in cheek). Duration of treatment ranged between one and 30 weeks with an average of 14.2 ± 11.4 SD weeks. The dose of propranolol ranged between 12 mg/kg with an average of 1.2 mg/kg and only one patient with upper eyelid and forehead extension needed 4 mg/kg. The color blanched in all patients after one week. The capillary hemangioma decreased in size after one week of treatment in two (18%) patients, and in all of them after one month. Complete regression of the hemangioma was seen in two (18%) cases one after two months and the other after 4 months of treatment. Five (45%) cases had astigmatism before the start of treatment (mean ±SD, 0.9 ± 0.379 D) diopters and improved to mean ±SD, 0.56 ± 0.586 D. Conclusion: Oral propranol can be used as a modality for therapy of infantile capillary hemangioma.