title: Risk factors for amblyopia in children with capillary hemangiomas of the eyelids and orbit.
abstract: BACKGROUND
  Capillary hemangiomas are the most common orbital tumors of childhood and can cause amblyopia secondary to occlusion of the pupil, anisometropia, or strabismus. We undertook this study to describe the clinical characteristics of children with capillary hemangiomas and to propose a classification system to guide clinical treatment decisions.
  
  
  METHODS
  A retrospective review of the records of 129 patients with 132 capillary hemangiomas in two pediatric ophthalmology practices was conducted. Hemangiomas were classified based on size. Presence of aniosometropic astigmatism, ptosis, pupillary occlusion, lid margin change, proptosis, globe displacement, and strabismus was recorded.
  
  
  RESULTS
  Thirty-one hemangiomas measured less than 1 cm in greatest dimension and were not associated with amblyogenic factors. Seventy-five patients had hemangiomas that measured greater than 1 cm, 40 of which were associated with amblyopia. Eighteen children had diffuse hemangiomas that could not be measured and 14 of these were associated with amblyopia. Five of seven hemangiomas in six patients with PHACES syndrome were associated with amblyopia.
  
  
  CONCLUSIONS
  This study is the largest review of capillary hemangiomas of the orbit and eyelids. Our findings suggest that size greater than 1 cm in largest diameter is an important predictor of amblyogenic factors and approximately half of these patients will require treatment. Diffuse hemangiomas and hemangiomas in patients with PHACES syndrome will cause amblyopia in the majority of cases.
authors.affiliation: Department of Ophthalmology, North Shore-Long Island Jewish Health Systems, Great Neck, New York, USA.
authors.forename: Shirah R
authors.initials: SR
authors.lastname: Schwartz
authors.forename: Francine
authors.initials: F
authors.lastname: Blei
authors.forename: Emily
authors.initials: E
authors.lastname: Ceisler
authors.forename: Mark
authors.initials: M
authors.lastname: Steele
authors.forename: Louis
authors.initials: L
authors.lastname: Furlan
authors.forename: Sylvia
authors.initials: S
authors.lastname: Kodsi
mesh_terms: D000550:Amblyopia / Q000453:epidemiology / Q000209:etiology*; D018450:Disease Progression; D005142:Eyelid Neoplasms / Q000150:complications* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D018324:Hemangioma, Capillary / Q000150:complications* / Q000473:pathology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009918:Orbital Neoplasms / Q000150:complications* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index