Original articleReappraisal of Astigmatism Induced by Periocular Capillary Hemangioma and Treatment with Intralesional Corticosteroid Injection
Section snippets
Materials and Methods
Records of 14 infants with PCH treated consecutively with intralesional corticosteroid injections for astigmatism at Children’s Hospital and Regional Medical Center between January 1994 and June 2005 were reviewed. Infants with papillary occlusion due to eyelid ptosis were excluded. Threshold for treatment was anisometropic astigmatism of at least 1.50 diopters (D). All infants were treated before 1 year of age by one of the authors (AHW). We limited our analysis to 13 of the 14 infants who had
Results
Our study included 13 infants (10 female) with a mean age of 4.7±2.7 months (range, 2–10) at initial ophthalmologic examination (Table 1 [available at http://aaojournal.org]). All infants had capillary hemangiomas confined to the periocular region. Nine infants had upper lid involvement; 3 of these had orbital extension. Four infants had lower lid involvement. The basal dimensions of all tumors were at least 1.0×1.0 cm. Follow-up acuity and refractive data were collected for a mean duration of
Discussion
We found that a single intralesional corticosteroid injection in infancy resulted in a 63% reduction in the mean amount of astigmatism induced by PCH. Our observations confirm those of previous investigators. Kushner reported a 64% reduction in anisometropic astigmatism of ≥2.50 D in 3 infants between 2 and 10 months of age.6 Morrell and Willshaw showed a 56% reduction of astigmatism of ≥1.50 D in 6 of 6 infants younger than 1 year and minimal or no reduction in 3 of 4 older children.9 Similar
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Manuscript no. 2006-1134.
Work done in the Roger H. Johnson Clinical Vision Laboratory, Children’s Hospital and University of Washington Medical Centers. Preliminary draft presented at: Association for Pediatric Ophthalmology and Strabismus annual meeting, 2006, Keystone, Colorado.
Supported by an unrestricted grant from the Peter LeHaye, Barbara Anderson, and William O. Rogers Funds.