A review of 58 patients with periorbital haemangiomas to determine appropriate cases for intervention.

Abstract

Periorbital haemangiomas cause severe effects on visual development. They can be treated with some success, but there is currently no literature on the selection of patients for intervention. Our study aims to review all periorbital haemangioma cases in Edinburgh over the past 20 years, to set more stringent guidelines regarding the appropriate selection of patients for treatment and determine prognostic indicators of visual outcome. A review of 58 patients since 1980 with significant lesions, seen by ophthalmologists and/or plastic surgeons. 82% of those presenting were female. The mean age of presentation was 4 months and 2 months in more serious cases. Mean follow up was for 5.6 (range 0-15) years. Loss of visual field was the most sensitive prediction of the development of visual complications (67%), but least specific (76%). Pressure on the globe and pupillary obstruction were more specific (77-100%), but less sensitive (33-50%). Loss of visual field, partial/complete pupillary obstruction and pressure exerted on the globe are all valuable prognostic indicators. The size and position of the lesion are also relevant, but are probably due to these factors. Based on these results we recommend specific guidelines for the selection of patients for intervention.