To compare intralesional and oral propranolol for treating periorbital and eyelid capillary hemangiomas

Indian J Ophthalmol. 2019 Dec;67(12):1974-1980. doi: 10.4103/ijo.IJO_59_19.

Abstract

Purpose: A pilot randomized control trial to compare the efficacy and side effects of intralesional and oral propranolol in periorbital and eyelid capillary hemangiomas.

Methods: Twenty patients were prospectively randomized to two groups of ten each. Group 1 was initiated on oral propranolol 1 mg/kg/day titrated to final dose of 3 mg/kg/day over 1 week which was continued for 6 months and then tapered over 1 week; Group 2 received 3 doses of direct intralesional propranolol hydrochloride 1 mg/ml; 0.2 ml/cm 4-6 weeks apart. Hemangioma area and corneal astigmatism were measured.

Results: Within each group at 6 months there was a significant reduction in area (group 1: 83.48 ± 11.67%,P= 0.0019; group 2: 67.78 ± 21.71%,P= 0.0019) and improvement in astigmatism (pre, post: group 1: 2.98D @ 179.8°, 1.13D @ 179.8°,P= 0.0045; group 2: 1.62D @ 90.16°, 0.75D @ 179.9°,P= 0.0001). There was no difference in area reduction (P = 0.056), change in appearance (P = 0.085), ptosis (P = 0.23) and side effects (lethargy, poor feeding;P= 0.171) between the two groups.

Conclusion: Efficacy and side effects with intralesional propranolol are comparable to oral propranolol for periorbital and eyelid lesions.

Keywords: Capillary hemangioma; intralesional propranolol; oral propranolol.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Adrenergic beta-Antagonists / administration & dosage*
  • Eyelid Neoplasms / drug therapy*
  • Eyelid Neoplasms / pathology
  • Female
  • Hemangioma, Capillary / drug therapy*
  • Hemangioma, Capillary / pathology
  • Humans
  • Infant
  • Injections, Intralesional
  • Male
  • Orbital Neoplasms / drug therapy*
  • Orbital Neoplasms / pathology
  • Pilot Projects
  • Propranolol / administration & dosage*
  • Prospective Studies
  • Treatment Outcome

Substances

  • Adrenergic beta-Antagonists
  • Propranolol