clobetasol and Hemangioma--Capillary

Capillary hemangiomas of the eyelid and orbit are treated when amblyopia secondary to anisometropic astigmatism or pupillary occlusion is present or when rapid growth of the hemangioma threatens to occlude the pupil. The goal of this study was to determine whether treatment of hemangiomas resolves or prevents occlusion or results in decrease in astigmatism.. The records of 54 patients who underwent treatment for reduction in the size of a capillary hemangioma causing amblyopia or threatened amblyopia in two pediatric ophthalmology practices were reviewed.. Twenty-eight patients were treated for amblyopia due to anisometropic astigmatism. The average amount of pretreatment astigmatism was 2.71 D, while the average amount of post-treatment astigmatism was 0.46 D. Fifteen of these patients could be tested for optotype visual acuity and all had vision acuity of 20/40 or better. Only 1 of the 15 patients treated for threatened occlusion of the pupil developed occlusion. Six of these patients cooperated with optotype visual acuity and all had vision acuity of 20/30 or better. Eleven patients were treated for pupillary occlusion. Occlusion resolved in all cases. Of the five patients treated for occlusion who cooperated with optotype visual acuity, two had a vision acuity of 20/100 or worse.. Treatment to reduce the size of capillary hemangiomas results in resolution of occlusion, reduction in astigmatism, and prevention of pupillary occlusion. Those with occlusion are at higher risk for severe residual amblyopia and require prompt and definitive treatment.

Topics: Amblyopia; Anisometropia; Astigmatism; Betamethasone; Clobetasol; Drug Therapy, Combination; Eyelid Neoplasms; Female; Glucocorticoids; Hemangioma, Capillary; Humans; Infant; Infant, Newborn; Injections, Intralesional; Male; Orbital Neoplasms; Retrospective Studies; Sensory Deprivation; Triamcinolone Acetonide

Hemangiomas pose a therapeutic challenge because they can threaten vision in infancy and early childhood. Intralesional injection of corticosteroid is widely regarded as the treatment of choice for hemangiomas which induce strabismus or significant refractive error, or occlude the visual axis. Ocular and systemic complications such as eyelid necrosis, central retinal artery occlusion, and adrenal suppression have been reported rarely after corticosteroid injection.. Three infants were treated with clobetasol propionate (Temovate) cream for vision-threatening eyelid hemangiomas.. Treatment with this topical fluorinated corticosteroid produced a measurable reduction in the size of the hemangiomas, which permitted clearing of the visual axis. No regional side effects were noted. In addition, the patients did not demonstrate evidence of hypothalamic-pituitary-adrenal axis suppression.. This treatment modality appears to provide an additional alternative for managing superficial periocular hemangiomas which threaten vision.

Topics: Administration, Topical; Anti-Inflammatory Agents; Child, Preschool; Clobetasol; Eyelid Neoplasms; Female; Glucocorticoids; Hemangioma, Capillary; Humans; Infant; Male; Ointments; Treatment Outcome