Preventing the development of visual defects with early treatment in cases diagnosed with periocular hemangioma: A single center experience

Abstract

Introduction: Hemangiomas are benign vascular tumors that are common in childhood. If located around the orbit, it may cause amblyopia and permanent vision defects. Therefore, early treatment is very important. Our aim in this study is to assess the treatment outcomes and clinical characteristics of patients with periocular hemangioma. Materials and Methods: Cases with periocular hemangioma who applied to the clinic between 2013 and 2023 were included in this study. The data of the cases were examined from hospital records. Propranolol treatment was used in patients at a dose of 1-2 mg/kg/day. During the follow-up, blood sugar, heart rate and blood pressure were monitored. Treatment responses of the patients were obtained from the hemangioma photo archive. Results: Of the 55 patients included in the study, 67.3% (n = 37) were female and 32.7% (n = 18) were male. Their average age was 6.7 months (1-36). There was a history of premature birth in 25.5% (n=14) of the cases. Three cases were diagnosed with PHACE syndrome. According to the location, the most common hemangioma was in the upper eyelid in 45.5% (n=25) of the cases, and the second most frequent was in the lower eyelid in 32.7% (n=18). Oral propranolol was started in 87.2% (n=48), topical timolol maleate treatment was started in 5.5% (n=3), and oral glucocorticoid and propranolol treatment was started in 3.6% (n=2). The average treatment duration of the patients was 12.8 (+/- 9.8) months. In the evaluation made according to treatment response, a complete or almost complete response to treatment was obtained in 60% (n = 33) of the cases, and a partial response was obtained in 25.5% (n=14) of the cases. Amblyopia developed in 9.1% (n=5) cases. At the last follow-up, visual impairment was observed in two cases. Conclusion: Amblyopia still poses a great risk if the patient is not followed well. It may cause permanent vision loss. Propranolol treatment provides great benefits. However, due to its side effects, it should be started in experienced centers.