Running title: propranolol versus corticosteroids for peri-orbital infantile hemangiomas

purpose To compare our results with intralesional corticosteroids (IC) injections to those with oral propranolol (P) medication in children with a peri-orbital infantile hemangioma (IH). design Retrospective comparison of two treatment groups. participants Children diagnosed with IH and treated with IC (n = 29) or P (n = 14) by the multidisciplinary task force of the Academic Medical Center in Amsterdam, from July of 2004 through December of 2011. methods Intralesional injections with a mixture of Kenacort and Solumedrol vs. oral propranolol treatment with a maximum of 3 mg/kg/day. In case no further improvement was objectified, treatment was stopped and the outcome measured. main Outcome measures Type, duration and complications of treatment, and supportive or additional therapies were scored. Outcomes of visual measurements, at the start and end of therapy, were scored. results The period of treatment was significant longer in the IC group. No major complications occurred in both groups. No significant difference was observed in prevalence of supportive therapy but more additional therapy was needed in the IC group. The levels of amblyopia and the median absolute improvement did not significantly differ between both groups. conclusions Because we found intralesional corticosteroid injections and oral propranolol medication to equally improve the level of amblyopia in children with IH of the peri-orbital and cheek region, but propranolol therapy to be associated with less complications and additional or supportive treatment, we prefer oral propranolol medication over the intralesional corticosteroid injections in cases where IHs threat to hamper visual acuity.