To explore the role of intralesional steroid injections (ILSI) and oral steroids in the management of periocular hemangioma
of infancy (HOI).
In this retrospective study, treatment options studied were observation, ILSI, and oral steroids. All children received adjunctive
amblyopia treatment if required. The main indications for treatment were cosmetic, worsening astigmatism, and visual axis
obscuration. Success was defined as complete HOI regression before the age of 5 years (cosmetic group), reduction of astigmatism
of at least 1 diopter cylinder (DC) (astigmatism group), or no evidence of amblyopia at the last follow-up (visual axis obscuration
Twenty-four of 41 children (58.5%) had amblyopia at presentation. Eighteen children formed the observation group, 17 children
received ILSI, and 6 children received oral steroids. Successful outcome was achieved in all except 2 patients in the cosmetic
group and 6 of 7 in the visual axis obscuration group. Mean astigmatic correction of all cases was 1.65 ± 1.34 DC before treatment
and 0.91 ± 1.17 DC after treatment, the change being statistically significant (
P < .001).
Observation appears to be a highly effective strategy if coupled with amblyopia therapy, especially for mild cases. Intralesional
and oral steroids appear to be equally effective for lesions requiring treatment, but their exact role cannot be clearly determined
in the presence of a spontaneously resolving lesion.
From The University of Manchester, Manchester Academic Health Science Centre, Manchester Royal Eye Hospital, Manchester, United Kingdom.
Supported by the NIHR Manchester Biomedical Research Centre.
Presented as a poster at the American Association for Pediatric Ophthalmology & Strabismus annual meeting, April 2–6, 2008, Washington, DC.
The authors have no financial or proprietary interest in the materials presented herein.
Address correspondence to Assad Jalil, MRCOphth, Manchester Royal Eye Hospital, Oxford Road, Manchester M13 9WH, United Kingdom. E-mail: email@example.com
Received: March 14, 2010
Accepted: May 03, 2010
Posted Online: July 22, 2010