Am J Ophthalmol
2018 Jan;185:48-55. doi: 10.1016/j.ajo.2017.10.021. Epub 2017 Nov 15.
Clinical and Radiological Evaluation of Periocular Infantile Hemangioma Treated With Oral Propranolol: A Case Series
Maria Antonieta Ginguerra, Osmar Saito, José Byron V D Fernandes, Deborah S Castro, Suzana Matayoshi
This article evaluated the clinical and radiological evolution of patients diagnosed with Infantile Periocular Hemangioma, who underwent systemic treatment with B-blocker. Nine cases were followed up, with periocular and orbital lesions that received Propranolol at a dose of 3mg / kg / day, for 1 year. Clinical and radiological efficacy were analyzed, through outpatient consultations, standardized photographs and ultrasound Doppler examination (USG) respectively, every 3 months. In this way, we were able to follow and compare the clinical parameters of the lesion reduction with the radiological ones. In the literature, we observed a certain difficulty in establishing the timing of medication withdrawal in the treatment of orbital hemangiomatous lesions, with a risk of recurrence. This study confirms the success in the clinical treatment with the use of Propranolol and proposes an innovative way, the use of the Index of Arterial Resistance (IR) of the USG Doppler, as an adjunctive measure in the decision to interrupt the treatment and withdraw the medication. Objectively, while using the medication, while the USG Doppler shows a continuous decrease in the volume and vascular density of the lesion, the RI undergoes a variation, with a sustained increase in the first six months, followed by a tendency to decrease. Through the analysis of the data of this reduction, it is proposed in a safer way to interrupt the treatment. The study was awarded in the Discipline of Ophthalmology HC-FMUSP.