Infantile Periocular Hemangioma

Abstract

Infantile periocular hemangiomas (IPH) are common benign vascular tumors that present early in childhood. They typically show a rapid nonlinear growth pattern a few weeks after birth during a proliferative phase, then continue with an involution phase and may result in serious ocular or systemic complications. Theses tumors may present in a range of small isolated lesions to multiple, diffuse involvements. Understanding the nature of the disease, the natural course, complications, indications for intervention, and treatment modalities would be helpful for ophthalmologists, who will likely be consulted for periocular cases. In this review, we present recent opinions about the pathogenesis, diagnosis, and treatment options for patients with IPH.

Keywords: Amblyopia; Children Eyelid Lesion; Corticosteroid Injection; Infantile Periocular Hemangioma; Systemic Propranolol.

Figure 1

Various presentations of periocular infantile hemangioma. Upper left: superficial, upper lid; upper right: deep upper lid and ocular surface; middle left: superficial lower lid; middle right: deep lower lid; lower left: extensive facial involvement; lower right: orbital involvement (confirmed by incisional biopsy).

Figure 2

Periocular infantile hemangioma at presentation (left, upper) and at 1 month (right upper), 3 months (left lower), and 12 months (right lower) after treatment with systemic propranolol and intralesional corticosteroid injection.

Figure 3

Infantile hemangioma with extensive hemifacial involvement before (left) and 2 months after (right) systemic propranolol.