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Propranolol treatment for periocular capillary haemangiomas – experience from a tertiary referral hospital
  1. LJ Clifford1,
  2. K May1,
  3. J Barling2
  1. 1Ophthalmology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  2. 2Child Health, University Hospital Southampton NHS Foundation Trust, Southampton, UK

Abstract

Aims To describe our experience in treating periocular capillary haemangiomas with propranolol.

Methods Descriptive case series. We describe the protocol used and our results including photographs pre-treatment and showing the treatment response. We also discuss the side effects and complications we have encountered.

Results We have a cohort of 8 patients (2 orbital, 5 periocular, and 1 brow haemangioma). We use a starting dose of 1 mg/kg/day in 3 divided doses increasing to 2 mg/kg/day after 1 week if tolerated.

Six of our patients have responded very well to the treatment and have had no side effects to date. One patient has only recently commenced treatment.

The propranolol was stopped in one case due to loss of appetite which coincided with the commencement of propranolol but has recently been restarted. We have had one drug error where the dispensing community pharmacist gave the 50 mg/5 ml propranolol concentration with labelled dose for 5 mg/5 ml concentration resulting in the infant receiving ten times the prescribed dose. He was admitted for monitoring with no ill effect.

Photo of one of our patients pre and post treatment – figure 1 and 2.

Conclusion Propranolol is an effective treatment for periocular capillary haemangiomas. In our cases it has provided good functional and cosmetic outcomes and been well tolerated with no serious adverse effects to date.

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