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Christopher Weller, Ingrid U Scott, Jason Mayer, Ravi Patel, Michael Wilkinson; Non-Selective Beta Blocker Therapy in the Treatment of Non-Vision Threatening Periocular Infantile Hemangioma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):805.
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To examine the efficacy and safety of topical and systemic non-selective beta blocker therapy in the treatment of non-vision threatening periocular infantile hemangioma.
A retrospective chart review examining patients with the diagnosis of periocular infantile hemangioma treated at the Penn State Hershey Eye Center between 2008 and 2013 who received either topical, systemic, or combination non-selective beta blocker therapy was performed. To be included patients were required to have eyelid involving lesions deemed to be non-visually significant, as defined by induction of less then 1.5 diopters astigmatism, no significant ptosis or direct occlusion of visual axis, and no secondary strabismus, at treatment onset and have received non-selective beta blocker therapy initiated within the first year of life. Parameters evaluated included lesion response, time until response, progression to visual significance, and documented side effects.
Five patients meeting the inclusion criteria were identified. Four patients received oral therapy while one had combination topical and oral therapy. All patients experienced a decrease in lesion size and none of the lesions progressed to visual significance. No side effects were reported.
Infantile hemangiomas have an unpredictable growth phase with up to 80% of periocular lesions progressing to visual significance. Therapy for infantile hemangioma has historically been withheld until lesions are deemed to be visually significant. Our results suggest that prophylactic treatment of non-vision threatening periocular infantile hemangiomas with systemic or combination non-selective beta blocker therapy poses a safe and efficacious treatment option that may limit the amblyogenic risk associated with such lesions and should be considered in appropriate patients.
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