APR 30, 2010
Pediatric Ophth/Strabismus
The authors report on the case of a 4-month-old female with infantile hemangioma treated with systemic propranol. Before treatment, the infant had experienced progressive painless protrusion of the right eye for three months. Subsequent examination revealed axial proptosis of the right globe and fullness of the eyelid, and later biopsy revealed a hypercellular tumor capillary in nature and composed of variably sized lobules.
Intravenous propranol treatment was initiated at 2 mg/kg/d for five days and then continued orally at home at the same dosage. At six weeks follow-up, there was no obvious proptosis, and MRI at three months revealed complete resolution of the orbital tumor with restoration of an unremarkable retrobulbar fat pattern. Treatment continued until the patient reached age 1, at which point it was tapered over a one-month period. At nine months follow-up, the patient had experienced no adverse effects or recurrence.
The authors concluded that propranol could become the preferred tool for the treatment of deep orbital and other inaccessible infantile hemangiomas.