Clinical review of periorbital capillary hemangioma of infancy.
OBJECTIVE
To explore the role of intralesional steroid injections (ILSI) and oral steroids in the management of periocular hemangioma of infancy (HOI).


METHODS
In this retrospective study, treatment options studied were observation, ILSI, and oral steroids. All children received adjunctive amblyopia treatment if required. The main indications for treatment were cosmetic, worsening astigmatism, and visual axis obscuration. Success was defined as complete HOI regression before the age of 5 years (cosmetic group), reduction of astigmatism of at least 1 diopter cylinder (DC) (astigmatism group), or no evidence of amblyopia at the last follow-up (visual axis obscuration group).


RESULTS
Twenty-four of 41 children (58.5%) had amblyopia at presentation. Eighteen children formed the observation group, 17 children received ILSI, and 6 children received oral steroids. Successful outcome was achieved in all except 2 patients in the cosmetic group and 6 of 7 in the visual axis obscuration group. Mean astigmatic correction of all cases was 1.65 ± 1.34 DC before treatment and 0.91 ± 1.17 DC after treatment, the change being statistically significant (P < .001).


CONCLUSIONS
Observation appears to be a highly effective strategy if coupled with amblyopia therapy, especially for mild cases. Intralesional and oral steroids appear to be equally effective for lesions requiring treatment, but their exact role cannot be clearly determined in the presence of a spontaneously resolving lesion.
Jalil
Assad
A
The University of Manchester, Manchester Academic Health Science Centre, Manchester Royal Eye Hospital, Manchester M13 9WH, United Kingdom. assadjalil@hotmail.com
Maino
Anna
A
Bhojwani
Rajan
R
Vose
Mark
M
Ashworth
Jane
J
Lloyd
I C
IC
Biswas
Susmito
S
D000550:Amblyopia / Q000628:therapy; D001251:Astigmatism; D018324:Hemangioma, Capillary / Q000188:drug therapy; D006801:Humans; D015552:Injections, Intralesional; D012189:Retrospective Studies