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Original Article
Management of orbital lymphangioma using intralesional injection of OK-432
  1. Yasuhito Suzukia,
  2. Akira Obanaa,
  3. Yuko Gohtoa,
  4. Tokuhiko Mikia,
  5. Hisasi Otukab,
  6. Yuichi Inouec
  1. aDepartment of Ophthalmology, Osaka City University Medical School, bDepartment of Ophthalmology, Kashihara City Hospital, cDepartment of Radiology, Osaka City University Medical School
  1. Dr Yasuhito Suzuki, Department of Ophthalmology, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno-ku, Osaka City, 545-8585, Japanm5253565{at}msic.med.osaka-cu.ac.jp

Abstract

AIM To treat orbital lymphangioma with an intralesional injection of OK-432 (group AStreptococcus pyogenes of human origin).

METHOD A 14 year old boy had a right orbital cystic lymphangioma. The visual acuity in the eye was 20/28. In an initial treatment, 0.02 mg of OK-432, was injected into the tumour after aspiration of the fluid contents, but no effect was seen. The second treatment was performed with 0.04 mg of OK-432.

RESULT 4 months later, the lesion had totally shrunk to fibrous tissue. The side effects were fever, a local inflammatory reaction lasting 3 days, and increased intraocular pressure, which was managed by draining the fluid contents. Visual acuity improved to 20/15, and the visual field defect and restriction of eye movement seen before treatment disappeared. No recurrence was noted 1 year after treatment.

CONCLUSION An intralesional injection of OK-432 shrunk the lymphangioma without functional disturbance and scar in the facial skin. OK-432 may be useful for orbital lymphangioma, but further studies are still warranted to determine efficacy, complications, and the optimal dose for safe treatment.

  • orbital lymphangioma
  • Streptococcus pyogenes
  • intralesional injection

https://doi.org/10.1136/bjo.84.6.614

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