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Propranolol treatment of capillary hemangiomas in infants yields positive results
The hemangioma size was considerably reduced at 6-month follow-up.
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Treatment with propranolol significantly reduced refractive error and anisometropia in infants with periocular capillary hemangiomas, according to a study.
“Propranolol seems to be effective in infants with capillary hemangioma, but I think we already knew that,” Peter J. Glasman, MbChB, told Ocular Surgery News. “One of the problems with studies that have already existed in this area was that people looked at the outcomes for astigmatism, but they used the cylinder subtraction method. If you want to compare refractive outcomes, then you need to use the matrix formalism or something similar.”
The study was published in the Journal of Pediatric Ophthalmology & Strabismus.
Patients and methods
The retrospective study included 17 patients with capillary hemangioma who were treated with 1 mg/kg propranolol three times a day for a mean of about 7 months. On the first day of treatment, the three doses were given at the hospital, and patients then continued the regimen on an outpatient basis. Researchers monitored patients’ blood pressure, pulse and respiratory status at follow-up appointments.
“We involved a pediatric team for the children who were initially admitted for the day to make sure they were not going to have any adverse effects on the patient and the family. We only had one patient who was unable to continue treatment because of side effects [wheeze],” Glasman said.
Researchers collected refractive data at 1 month, 3 months, 6 months and 1 year after the start of treatment and analyzed refractive data through Long’s matrix formalism and the methods of Harris and Kaye.
Outcomes
Four of the 17 patients experienced wheeze. One did not continue treatment, and three continued propranolol therapy.
At 6 months, the mean size of the hemangioma decreased from 3,214 mm3 to 1,806 mm3. Also, the magnitude and variability of refractive error were significantly reduced in the affected eye at month 6 (P = .048 and P = .0006, respectively).
The change in mean refraction from before treatment to 6 months after the start of treatment was –1.25/+0.38 × 36 in the affected eye and –1.01/+0.31 × 3 in the unaffected eye.
Anisometropic refractive error was insignificantly reduced with the treatment, but variability of anisometropia was significantly reduced.
“Although we did not have a control group, we do have a control eye in that one of the eyes was unaffected by hemangioma, so we did have something to compare with, but certainly it would have improved quality if we would have had a control group,” Glasman said. – by Nhu Te
Reference:
Glasman P, et al. J Pediatr Ophthalmol Strabismus. 2014;doi:10.3928/01913913-20140507-03.For more information:
Peter J. Glasman, MbChB, can be reached at St. Paul’s Eye Unit, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, United Kingdom; email: peter.glasman@doctors.net.uk.Disclosure: Glasman has no relevant financial disclosures.