Intralesional and sub-Tenon's infusion of corticosteroids for treatment of refractory periorbital and orbital capillary haemangioma.
OBJECTIVE
To evaluate the effect of combined intralesional and sub-Tenon's administration of corticosteroids for the treatment of refractory periocular and orbital capillary haemangioma in a retrospective, non-comparative study.


METHODS
Seven infants with resistant periorbital and orbital capillary haemangioma who attended our tertiary centre from 2000 to 2005 were treated with an intralesional injection of a mixture of betamethasone 6 mg/cc and triamcinolone 10 mg/cc, by body weight, together with sub-Tenon's infusion of betamethasone 6 mg/cc and triamcinolone 40 mg/cc of a volume of 1 cc, close to the orbital lesion, in the same session. Visual axis, proptosis, pre- and post-treatment changes in four refractive parameters, and parental satisfaction were evaluated.


RESULTS
None of the babies had proptosis or visual axis obstruction after treatment. Mean spherical power decreased by 22.7% (P=0.06). Mean spherical equivalent decreased in 34%, but the difference was not statistically significant (P=0.09). No early or late ocular side effects were observed. Mean intraocular pressure results were normal before and immediately after treatment, and during the follow-up period. Parental satisfaction score during follow-up was 9/10. Mean time to improvement was 96.43+/-58.3 days.


CONCLUSIONS
Combined local corticosteroid administration by posterior sub-Tenon's infusion and intralesional injection in babies with extensive capillary haemangioma is associated with a satisfactory anatomical and functional outcome and there were no ophthalmic side effects.
Friling
R
R
Paediatric Ophthalmology Unit, Schneider Children's Medical Centre of Israel, Sackler Faculty of Medicine, Tel Aviv University, Petah Tiqwa, Israel. ronitf@post.tau.ac.il
Axer-Siegel
R
R
Ben-Amitai
D
D
Goldenberg-Cohen
N
N
Weinberger
D
D
Snir
M
M
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D001623:Betamethasone / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D018324:Hemangioma, Capillary / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D015552:Injections, Intralesional; D056965:Injections, Intraocular; D007429:Intraocular Pressure; D008297:Male; D009918:Orbital Neoplasms / Q000188:drug therapy*; D017060:Patient Satisfaction; D014221:Triamcinolone / Q000008:administration & dosage*
D000305:Adrenal Cortex Hormones; D014221:Triamcinolone; D001623:Betamethasone