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Imtiaz A Chaudhry, Fahad Al-Saikhan, Osama Al-Sheikh, Waleed Al-Rashed, Farrukh A Shamsi, Yonca O Arat, Milton Boniuk; Intralesional OK-432 (Picibanil) Sclerosing Agent in the Treatment of Orbital Lymphangiomas. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4081.
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Periocular lymphangioma is the 2nd most common vascular tumor after capillary hemangioma clinically apparent during the early years of childhood. Over the years, different sclerosing agents have been utilized with limited success. Our initial experience suggested that OK-432 (Picibanil) may be useful in the treatment of lymphangiomas in the orbital region. The purpose of this study is to report our experience with intra-lesional OK-432 for the treatment of orbital lymphangiomas.
A prospective, interventional case series of 12 patients with orbital lymphangiomas was conducted to asses efficacy of OK-432 regarding its use in the stabilizing or reduction of the tumor after intralesional administration. Demographic of these patients along with their response to the treatment was studied.
There were 9 patients (6 female, average age 9.5 years, range 1.6 to 25 years, 5 right side) who required an average of 2.2 injections (range 1-4) over a one month to 12 month period. Two patients had diffuse orbital hemorrhage in the cystic spaces after being discharged on the same day following interalesional OK-432 injections. With an average follow-up of 6.4 months (range 1.5 to 13 months), 8 patients (88.9%) showed either regression of the tumor size or resulted in stabilizing its further growth. Seven (87.5%) patients also showed partial to moderate response by improved vision, decreasing pain, or proptosis. One patient with a large cystic lesion did not benefit from the injection and required surgical excision.
This prospective study suggests that intra-lesional OK-432 may have beneficial effect in the control of orbital lymphangioma. Further larger well-controlled studies may be helpful to elucidate the long-term effect of the OK-432 sclerosing agent. Suzuki Y, Obana A, Gohto Y, Miki T, Otuka H, Inoue Y. Management of orbital lymphangioma using intralesional injection of OK-432. Br J Ophthalmol. 2000;84:614-7. Yoon JS, Choi JB, Kim SJ, Lee SY. Intralesional injection of OK-432 for vision-threatening orbital lymphangioma. Graefes Arch Clin Exp Ophthalmol. 2007;245:1031-5. Oyama T, Eguchi K, Cho H, Abe H. A variety of orbital lymphangioma treatments: one case treated with orbital decompression therapy and the other case with intralesional injection of OK-432 therapy. Nippon Ganka Gakkai Zasshi. 2009;113:732-40.
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