Comparative study of modification of the osmolarity in graft versus host disease.

Oral propranolol is a nonselective betablocker that could play a relevant role in exudative control of retinal hemangioblastomae, as during oral propranolol treatment the size of the lesion remained stable and exudative activity was entirely inhibited. The relapse exhibited by the patient during the months in which he discontinued propranolol treatment gave rise to its reintroduction. Since then, 18 months have passed without relapse, which led us to take the decision to prescribe the treatment indefinitely. Propranolol inhibits the vasodilating effect of adrenergic molecules by inhibiting Beta receptors of endothelial cells, promoting vasoconstriction and diminished blood flow in the hemangioma. In addition, it has some angiogenesisinhibiting capacity because adrenaline and noradrenaline can induce the expression of VEGF,4–6 and blocking the action of these molecules by means of propranolol could diminish the concentration thereof. There is a range of possible action mechanisms that reduce exudative activity and therefore treatment with oral propranolol could be considered as a therapeutic option in ocular hemangioblastomae that do not respond to conventional therapies. To the best of our knowledge, this is the first described case of a serous macular detachment secondary to CRH successfully treated with oral propranolol. Subsequent studies should be proposed to confirm the potential efficacy of propranolol in the treatment of CRH.