title: Treatment of periocular infantile hemangiomas with propranolol: case series of 18 children.
abstract: OBJECTIVE
  To study the efficacy of propranolol in the treatment of periocular infantile hemangiomas (IHs).
  
  
  METHODS
  Retrospective interventional case series.
  
  
  METHODS
  Eighteen children presenting periocular IH with occlusion of the pupil, anisometropic astigmatism, proliferating eyelid IH, or cosmetically disfiguring periocular IH.
  
  
  METHODS
  All patients received treatment with propranolol started at 0.5 mg/kg/day with an incremental increase by 0.5 mg/kg/day every 4 days, up to a maximum of 2 to 3 mg/kg/day. Complete eye examinations and serial photographs were obtained before, during, and after treatment. Doppler ultrasound and magnetic resonance imaging performed pre- and post-treatment were compared when available.
  
  
  METHODS
  Evolution of the treated IH was evaluated with respect to astigmatism, amblyopia, and size of the lesion.
  
  
  RESULTS
  The IH size decreased in 17 of 18 patients. We noted a greater reduction when treatment was administered during the proliferative phase of growth of IHs. At the conclusion of treatment, none of our patients had amblyopia. The mean value of amblyogenic astigmatism (n = 7) decreased from 2.71 diopters (D) pretreatment to 1.03 D post-treatment. On radiology, 8 patients had significant regression of the lesion size of their IH and 1 patient had a limited progression. Propranolol had to be temporarily discontinued in only 1 patient because of symptomatic hypotension.
  
  
  CONCLUSIONS
  Propranolol seems to be an effective modality of treatment for periocular IH. It seems to be most efficacious when initiated in the proliferative phase of IH but may be beneficial even in the later stage.
  
  
  BACKGROUND
  The author(s) have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: Division of Dermatology, CHU Sainte Justine, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Rola
authors.initials: R
authors.lastname: Al Dhaybi
authors.forename: Rosanne
authors.initials: R
authors.lastname: Superstein
authors.forename: Ariane
authors.initials: A
authors.lastname: Milet
authors.forename: Julie
authors.initials: J
authors.lastname: Powell
authors.forename: Josée
authors.initials: J
authors.lastname: Dubois
authors.forename: Catherine
authors.initials: C
authors.lastname: McCuaig
authors.forename: François
authors.initials: F
authors.lastname: Codère
authors.forename: Afshin
authors.initials: A
authors.lastname: Hatami
authors.forename: Line
authors.initials: L
authors.lastname: Chevrette
authors.forename: Nicole
authors.initials: N
authors.lastname: Fallaha
authors.forename: Patrick
authors.initials: P
authors.lastname: Hamel
authors.forename: Luis H
authors.initials: LH
authors.lastname: Ospina
mesh_terms: D000284:Administration, Oral; D004305:Dose-Response Relationship, Drug; D005142:Eyelid Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D018324:Hemangioma, Capillary / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011433:Propranolol / Q000008:administration & dosage*; D012189:Retrospective Studies; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D011433:Propranolol