Monitoring propranolol treatment in periocular infantile haemangioma

Eye (Lond). 2014 Nov;28(11):1281-4; quiz 1285. doi: 10.1038/eye.2014.237. Epub 2014 Oct 17.

Abstract

Objective: To develop a tool for assessing amblyopic risk and monitoring the treatment effect of propranolol in periocular haemangioma management.

Methods: We present a study of nine children with periocular haemangioma who underwent propranolol treatment at York Hospital between 2009 and 2013.A proposed measure of amblyogenic risk based on the induced anisometropia resulting from a periocular haemangioma was calculated in the form of a single quantitative value, measured in dioptres. This calculation used published work and developed it to produce a new function, termed the delta defocus equivalent (DFE-∂).Refraction measurements were retrospectively collected from patients' notes in order to measure the trend of DFE-∂ over the treatment period with propranolol.

Results: The average DFE-∂ at commencement of propranolol was 1.54 (±0.62) D. The average at the end of treatment was 0.39 (±0.38) D.

Conclusion: This work presents a possible tool for assessing amblyopic risk in cases of periocular infantile haemangioma. The DFE-∂ gives a measure in dioptres, which may represent the true amblyopic risk, and so be useful in supporting treatment decisions in paediatric ophthalmology.

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adrenergic beta-Antagonists / therapeutic use*
  • Amblyopia / diagnosis
  • Amblyopia / etiology
  • Child
  • Child, Preschool
  • Drug Monitoring
  • Eyelid Neoplasms / drug therapy
  • Female
  • Hemangioma / drug therapy*
  • Humans
  • Infant
  • Male
  • Orbital Neoplasms / drug therapy
  • Propranolol / therapeutic use*
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Risk Assessment
  • Visual Acuity / physiology
  • Young Adult

Substances

  • Adrenergic beta-Antagonists
  • Propranolol