Intralesional and sub-Tenon's infusion of corticosteroids for treatment of refractory periorbital and orbital capillary haemangioma

Eye (Lond). 2009 Jun;23(6):1302-7. doi: 10.1038/eye.2008.300. Epub 2008 Nov 7.

Abstract

Purpose: To evaluate the effect of combined intralesional and sub-Tenon's administration of corticosteroids for the treatment of refractory periocular and orbital capillary haemangioma in a retrospective, non-comparative study.

Methods: Seven infants with resistant periorbital and orbital capillary haemangioma who attended our tertiary centre from 2000 to 2005 were treated with an intralesional injection of a mixture of betamethasone 6 mg/cc and triamcinolone 10 mg/cc, by body weight, together with sub-Tenon's infusion of betamethasone 6 mg/cc and triamcinolone 40 mg/cc of a volume of 1 cc, close to the orbital lesion, in the same session. Visual axis, proptosis, pre- and post-treatment changes in four refractive parameters, and parental satisfaction were evaluated.

Results: None of the babies had proptosis or visual axis obstruction after treatment. Mean spherical power decreased by 22.7% (P=0.06). Mean spherical equivalent decreased in 34%, but the difference was not statistically significant (P=0.09). No early or late ocular side effects were observed. Mean intraocular pressure results were normal before and immediately after treatment, and during the follow-up period. Parental satisfaction score during follow-up was 9/10. Mean time to improvement was 96.43+/-58.3 days.

Conclusions: Combined local corticosteroid administration by posterior sub-Tenon's infusion and intralesional injection in babies with extensive capillary haemangioma is associated with a satisfactory anatomical and functional outcome and there were no ophthalmic side effects.

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Betamethasone / administration & dosage*
  • Drug Therapy, Combination
  • Female
  • Hemangioma, Capillary / drug therapy*
  • Humans
  • Infant
  • Injections, Intralesional*
  • Injections, Intraocular*
  • Intraocular Pressure
  • Male
  • Orbital Neoplasms / drug therapy*
  • Patient Satisfaction
  • Triamcinolone / administration & dosage*

Substances

  • Adrenal Cortex Hormones
  • Triamcinolone
  • Betamethasone