Alternative treatment modality for periocular infantile hemangioma

Abstract

Background: Capillary hemangiomas are the most common tumors of the eyelids and orbit in children. They typically appear at or shortly after birth, with approximately 90% being clinically obvious by 2 months of age. Complications include functional sequelae like anisometropia, amblyopia, visual axis impairment; cosmetic sequelae like scarring, ulceration, bleeding, displacement of the globe, proptosis and even optic nerve compression. Therapeutic options include corticosteroids, beta-blockers, pulse dye laser, topical imiquimod, interferon-α, vincristine, cyclophosphamide and surgery. Aim: The aim of our study is to investigate the efficacy of intralesional triamcinolone and combination of intralesional triamcinolone with topical timolol in treatment of periocular infantile hemangioma & its recurrence. Method: This prospective study was performed in 24 patients with periocular hemangiomas requiring intervention. Patients were arranged in two groups: Triamcinolone acetonide intralesional injection alone & combination of triamcinolone acetonide intralesional injection with timolol maleate local application. Patients were followed up for three months. The size of the hemangioma was measured in mm2. Result: In Group 1, 66.66% of patients showed good response while in group 2, 88.89% of patients showed good response. Group 2 showed less recurrence rate than group 1. None of the patients developed local side effects during or after injection. Conclusion: Beta blocker and intralesional steroid both are relatively safe and effective for the periocular capillary hemangioma. Beta blocker with intralesional steroid has less chances of recurrence than beta blocker and steroid alone. Keywords: Infantile hemangioma, Triamcinolone acetonide, Timolol maleate.