Oral propranolol for the treatment of periorbital infantile hemangioma: a preliminary report from oman.
OBJECTIVE
To investigate the efficacy and safety of oral propranolol in the management of periorbital infantile hemangioma in four subjects.


METHODS
Consecutive patients who presented with periorbital capillary hemangioma with vision-threatening lesions were prospectively enrolled in this study between January 2009 and October 2010. All subjects underwent treatment with 2 mg/kg/day oral propranolol. All subjects underwent ocular, systemic, and radiologic evaluations before treatment and at periodic intervals after starting therapy. Side effects from therapy were also evaluated.


RESULTS
Four subjects, between 3 months and 19 months of age, with periorbital hemangioma were enrolled in this study. Two subjects had been previously treated with oral corticosteroids with unsatisfactory response. All subjects had severe ptosis, with the potential for deprivation amblyopia. Three subjects had orbital involvement. After hospital admission, oral propranolol was initiated in all subjects under monitoring by a pediatric cardiologist. Subsequent therapy was performed with periodic out-patient monitoring. All subjects had excellent response to treatment, with regression of periorbital and orbital hemangioma. There were no side effects from therapy.


CONCLUSIONS
Oral propranolol for periorbital hemangioma was effective in all the four subjects. Oral propranolol may be appropriate for patients who are nonresponsive to intralesional or systemic steroids. In patients with significant orbital involvement and lesions causing vision-threatening complications, oral propranolol can be the primary therapy.
Department of Ophthalmology, Sultan Qaboos University Hospital, Muscat, Oman.
Beena
B
Harikrishna
Anuradha
A
Ganesh
Sana
S
Al-Zuahibi
Samia
S
Al-Jabri
Ahmed
A
Al-Waily
Adil
A
Al-Riyami
Faisal
F
Al-Azri
Feraz
F
Masoud
Abdullah
A
Al-Mujaini