Treatment of capillary hemangiomas causing refractive and occlusional amblyopia.
OBJECTIVE
Capillary hemangiomas of the eyelid and orbit are treated when amblyopia secondary to anisometropic astigmatism or pupillary occlusion is present or when rapid growth of the hemangioma threatens to occlude the pupil. The goal of this study was to determine whether treatment of hemangiomas resolves or prevents occlusion or results in decrease in astigmatism.


METHODS
The records of 54 patients who underwent treatment for reduction in the size of a capillary hemangioma causing amblyopia or threatened amblyopia in two pediatric ophthalmology practices were reviewed.


RESULTS
Twenty-eight patients were treated for amblyopia due to anisometropic astigmatism. The average amount of pretreatment astigmatism was 2.71 D, while the average amount of post-treatment astigmatism was 0.46 D. Fifteen of these patients could be tested for optotype visual acuity and all had vision acuity of 20/40 or better. Only 1 of the 15 patients treated for threatened occlusion of the pupil developed occlusion. Six of these patients cooperated with optotype visual acuity and all had vision acuity of 20/30 or better. Eleven patients were treated for pupillary occlusion. Occlusion resolved in all cases. Of the five patients treated for occlusion who cooperated with optotype visual acuity, two had a vision acuity of 20/100 or worse.


CONCLUSIONS
Treatment to reduce the size of capillary hemangiomas results in resolution of occlusion, reduction in astigmatism, and prevention of pupillary occlusion. Those with occlusion are at higher risk for severe residual amblyopia and require prompt and definitive treatment.
Schwartz
Shirah R
SR
North Shore-Long Island Jewish Health Systems, Department of Ophthalmology, Great Neck, NY 11021, USA.
Kodsi
Sylvia R
SR
Blei
Francine
F
Ceisler
Emily
E
Steele
Mark
M
Furlan
Louis
L
D000550:Amblyopia / Q000209:etiology*; D015858:Anisometropia / Q000150:complications; D001251:Astigmatism / Q000150:complications; D001623:Betamethasone / Q000627:therapeutic use; D002990:Clobetasol / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005142:Eyelid Neoplasms / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D018324:Hemangioma, Capillary / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015552:Injections, Intralesional; D008297:Male; D009918:Orbital Neoplasms / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D012683:Sensory Deprivation; D014222:Triamcinolone Acetonide / Q000627:therapeutic use
D005938:Glucocorticoids; D001623:Betamethasone; D002990:Clobetasol; D014222:Triamcinolone Acetonide