June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Current Practice Patterns in the Treatment of Periocular Infantile Hemangiomas.
Author Affiliations & Notes
  • Christopher Weller
    Ophthalmology, Penn State Hershey Eye Center, Middletown, PA
  • Ravi Patel
    Ophthalmology, Penn State Hershey Eye Center, Middletown, PA
  • Jason R Mayer
    Ophthalmology, Penn State Hershey Eye Center, Middletown, PA
  • Michael Wilkinson
    Ophthalmology, Penn State Hershey Eye Center, Middletown, PA
  • Ingrid U Scott
    Ophthalmology, Penn State Hershey Eye Center, Middletown, PA
  • Ajay Soni
    Ophthalmology, Penn State Hershey Eye Center, Middletown, PA
  • Footnotes
    Commercial Relationships Christopher Weller, None; Ravi Patel, None; Jason Mayer, None; Michael Wilkinson, None; Ingrid Scott, None; Ajay Soni, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 139. doi:https://doi.org/
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      Christopher Weller, Ravi Patel, Jason R Mayer, Michael Wilkinson, Ingrid U Scott, Ajay Soni; Current Practice Patterns in the Treatment of Periocular Infantile Hemangiomas.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):139. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To investigate whether the emergence of systemic and topical non-selective beta-blocker therapy has altered the practice patterns of pediatric ophthalmologists when treating infantile hemangiomas in the periocular region.

Methods: An anonymous fourteen question survey was constructed using surveymonkey.com. Participants were recruited for voluntary participation through advertisement in an AAPOS newsletter and postings on a pediatric ophthalmology listserv.

Results: A total of 205 fellowship trained pediatric ophthalmologists completed the survey. Respondents chose private (48%), academic (30%), or combination (22%) when asked to characterize their current practice landscape. Most respondents (71%) completed training greater than ten years ago. A majority (81%) noted their approach to the treatment of infantile hemangiomas changed over the past 5 years, with the most common change being the use of non-selective beta blocker therapy as identified by freetext response. For the treatment of non-vision threatening lesions, 43% of respondents selected observation as their preferred intervention, while 24% and 20% identified topical and systemic non-selective beta blocker therapy, respectively. Timolol 0.5% gel was the most commonly preferred topical therapy (38%). When treating vision-threatening lesions, 86% of respondents identified systemic non-selective beta blocker therapy as their preferred intervention. Prior to initiating systemic beta-blocker therapy, 92% utilized a pre-treatment screening protocol, 28% of which included inpatient observation, while only 27% employed a pre-treatment screening protocol prior to initiation of local beta-blocker therapy.

Conclusions: The discovery of non-selective beta-blocker therapy for the treatment of infantile hemangiomas has altered the approach of pediatric ophthalmologists when treating such lesions in the periocular region. A predominant percentage of those polled identified systemic non-selective beta-blocker therapy as their preferred intervention for vision-threatening lesions and employed a pre-treatment screening protocol prior to initiation of therapy. No clear-cut approach to non-vision threating lesions was identified. In such cases, the determination for intervention may be guided by factors not explored in our survey, such as aesthetic concerns or ambylogenic potential; this serves as a potential area for future investigation.

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