Treatment of orbital vascular malformations with intralesional injection of pingyangmycin

Br J Ophthalmol. 2013 Jun;97(6):739-45. doi: 10.1136/bjophthalmol-2012-302900. Epub 2013 Apr 19.


Background: To evaluate the safety and efficacy of intralesional pingyangmycin for treatment of orbital vascular malformations.

Methods: Thirteen patients received intralesional injections of pingyangmycin at the Eye and ENT Hospital of Fudan University. CT scans of each patient were evaluated with graphic processing software to measure lesion volumes before and after treatment.

Results: Of five men and eight women patients averaging 36 years old, six were diagnosed with venous malformations, six with cavernous haemangiomas, and one with lymphangioma. Proptosis and eyelid swelling were the most common presenting signs. The mean preoperative lesion volume was 4.4±2.3 cm(3) (range, 1.6-8.8 cm(3)), and the average postoperative volume was 1.5±1.7 cm(3) (range, 0.2-6.6 cm(3)) after a single pingyangmycin injection, the dose of which averaged 4.2 mg (range, 2-6 mg). The mean percentage of volume reduction was 70.0% (range, 24.5-88.3%), whereas proptosis reduction averaged 3.2 mm (range, 0-5.5 mm). The lesion volume and proptosis reductions were both statistically significant (p<0.001, and p=0.001). No adverse local or systemic side effects occurred in any of the patients during follow-up averaging 13.3 months. Histopathology of a cavernous haemangioma that underwent a second injection through a surgical incision, showed a mild chronic inflammatory response, increased numbers of myofibroblasts, loss of vascularity and fibrosis, all consistent with known effects of bleomycin treatment.

Conclusions: Intralesional injection of pingyangmycin for the treatment of orbital vascular malformations is an effective method that involves mild inflammation, fibrosis, and reduced vascularity of the malformation.

Keywords: Drugs; Orbit; Pathology.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Antibiotics, Antineoplastic / administration & dosage
  • Antibiotics, Antineoplastic / adverse effects
  • Bleomycin / administration & dosage
  • Bleomycin / adverse effects
  • Bleomycin / analogs & derivatives*
  • Female
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted
  • Injections, Intralesional
  • Male
  • Middle Aged
  • Orbit / blood supply*
  • Orbit / diagnostic imaging
  • Orbital Neoplasms / diagnostic imaging
  • Orbital Neoplasms / drug therapy*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vascular Malformations / diagnostic imaging
  • Vascular Malformations / drug therapy*
  • Vascular Neoplasms / diagnostic imaging
  • Vascular Neoplasms / drug therapy*
  • Young Adult


  • Antibiotics, Antineoplastic
  • Bleomycin
  • bleomycetin