Effect of Oral Propranolol on Periocular Infantile Capillary Hemangioma: Outcomes Based on Extent of Involvement

PURPOSE: To evaluate the efficacy of oral propranolol in the treatment of periocular infantile capillary hemangioma (CHI) based on the involvement of embryological facial placodes and their extent of anatomical involvement. METHODS: Retrospective study of 27 patients. RESULTS: The mean age at the presentation of periocular CHI was 4 months (median, 3 months; range, <1–14 months). There were 11 (41%) males and 16 (59%) females. Based on embryological facial placodes, the involvement was focal in 16 (59%) cases and segmental in 11 (41%) cases. Based on the anatomical distribution, the lesions were preseptal in 4 (15%), postseptal in 13 (48%), and combined in 10 (37%) cases. The duration of use of oral propranolol was 10 months (median, 10 months; range, 4–16 months). Overall, the mean % resolution of periocular CHI was 78% (median, 90%; range, 20%–100%). The mean percentage resolution of focal lesions was 69% (median, 83%; range, 20%–100%), and segmental lesions were 92% (median, 95%; range, 70%–100%). The mean percentage resolution of preseptal component of lesions was 94% (median, 95%; range, 80%–100%) and postseptal component was 74% (median, 85%; range, 20%–100%) over a mean follow-up period of 16 months (median, 15 months; range, 4–37 months). Four (15%) patients exhibited flare-up of lesion after tapering oral propranolol. CONCLUSION: Oral propranolol is effective in the treatment of periocular CHI. Segmental and preseptal lesions respond better to the treatment compared to focal and postseptal lesions.