Real-life efficacy and safety of oral propranolol for ocular adnexal infantile hemangiomas: observational cohort study

ObjectiveTo assess the effectiveness and safety of oral propranolol for the treatment of ocular adnexal infantile hemangiomas.Patients and methodsretrospective observational cohort study. Propranolol was administered at an initial oral dose of 1 mg/kg and subsequently increased to 2 mg/kg for 1 year...

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Main Authors: Stefano Malvindi, Elena Sammarco, Andrea Elefante, Vittoria Lanni, Domenico Cicala, Francesco Esposito, Ciro Picardi, Adriana Iuliano, Dana Cohen, Giuseppe Mariniello, Antonella D’Aponte, Ciro Costagliola, Francesco Briganti, Diego Strianese
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Ophthalmology
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Online Access:https://www.frontiersin.org/articles/10.3389/fopht.2025.1493171/full
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author Stefano Malvindi
Elena Sammarco
Andrea Elefante
Vittoria Lanni
Domenico Cicala
Francesco Esposito
Ciro Picardi
Adriana Iuliano
Dana Cohen
Giuseppe Mariniello
Antonella D’Aponte
Ciro Costagliola
Francesco Briganti
Diego Strianese
author_facet Stefano Malvindi
Elena Sammarco
Andrea Elefante
Vittoria Lanni
Domenico Cicala
Francesco Esposito
Ciro Picardi
Adriana Iuliano
Dana Cohen
Giuseppe Mariniello
Antonella D’Aponte
Ciro Costagliola
Francesco Briganti
Diego Strianese
author_sort Stefano Malvindi
collection DOAJ
description ObjectiveTo assess the effectiveness and safety of oral propranolol for the treatment of ocular adnexal infantile hemangiomas.Patients and methodsretrospective observational cohort study. Propranolol was administered at an initial oral dose of 1 mg/kg and subsequently increased to 2 mg/kg for 1 year. Outcomes were evaluated by comparing pre- and post-treatment clinical findings, contrast-enhanced ultrasound (CEUS) findings and/or orbital magnetic resonance imaging findings from baseline to 3, 6, 9, 12, 24, and 48 weeks. Regression was graded as follows: satisfactory when 90% and above of the baseline lesion volume and extension decreased, acceptable when 50 to 90%, mediocre when 30 to 50%, poor less than 30%.ResultsTwenty-four patients were included in this study. The mean age at presentation was 4 ± 1 week. Sixteen (71%) patients were females and 7 (29%) were males. The mean follow-up duration was 18 ± 3 months. Therapy was started for of 23/24 patients at 5 weeks old, of 1/24 started at 9 weeks of age. The median age was 5,16 weeks. Sixteen patients (66%) had satisfactory resolution between 3 and 6 weeks, 5 (20%) after 9 weeks, and 3 (12%) after 12 weeks. One patient (5%) had a mediocre response after 24 weeks. One patient withdrew from therapy because of hypoglycemia, which was successfully managed as an outpatient. No significant adverse reactions, such as bradycardia, hypotension, bronchospasm, or congestive heart failure, were detected in this cohort.ConclusionThis study indicates that the real-life use of oral propranolol for infantile hemangioma yields a high success rate with a lower morbidity than previously reported, particularly when managed by a proficient and multidisciplinary team.
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spelling doaj-art-698f6b6e369d41cfa46b5053d7d3f5dc2025-08-20T03:52:29ZengFrontiers Media S.A.Frontiers in Ophthalmology2674-08262025-05-01510.3389/fopht.2025.14931711493171Real-life efficacy and safety of oral propranolol for ocular adnexal infantile hemangiomas: observational cohort studyStefano Malvindi0Elena Sammarco1Andrea Elefante2Vittoria Lanni3Domenico Cicala4Francesco Esposito5Ciro Picardi6Adriana Iuliano7Dana Cohen8Giuseppe Mariniello9Antonella D’Aponte10Ciro Costagliola11Francesco Briganti12Diego Strianese13Department of Neurosciences, Reproductive Sciences and Dentistry. University of Naples Federico II, Naples, ItalyPediatric Neuroradiology, Department of Neuroscience, Santobono-Pausilipon Children’s Hospital, Naples, ItalyDepartment of Advanced Biomedical Sciences, University of Naples Federico II, Naples, ItalyDepartment of Neurosciences, Reproductive Sciences and Dentistry. University of Naples Federico II, Naples, ItalyPediatric Neuroradiology, Department of Neuroscience, Santobono-Pausilipon Children’s Hospital, Naples, ItalyPediatric Neuroradiology, Department of Neuroscience, Santobono-Pausilipon Children’s Hospital, Naples, ItalyPediatric Neuroradiology, Department of Neuroscience, Santobono-Pausilipon Children’s Hospital, Naples, ItalyDepartment of Neurosciences, Reproductive Sciences and Dentistry. University of Naples Federico II, Naples, ItalyDepartment of Neurosciences, Reproductive Sciences and Dentistry. University of Naples Federico II, Naples, ItalyDepartment of Neurosciences, Reproductive Sciences and Dentistry. University of Naples Federico II, Naples, ItalyDepartment of Neurosciences, Reproductive Sciences and Dentistry. University of Naples Federico II, Naples, ItalyDepartment of Neurosciences, Reproductive Sciences and Dentistry. University of Naples Federico II, Naples, ItalyDepartment of Advanced Biomedical Sciences, University of Naples Federico II, Naples, ItalyDepartment of Neurosciences, Reproductive Sciences and Dentistry. University of Naples Federico II, Naples, ItalyObjectiveTo assess the effectiveness and safety of oral propranolol for the treatment of ocular adnexal infantile hemangiomas.Patients and methodsretrospective observational cohort study. Propranolol was administered at an initial oral dose of 1 mg/kg and subsequently increased to 2 mg/kg for 1 year. Outcomes were evaluated by comparing pre- and post-treatment clinical findings, contrast-enhanced ultrasound (CEUS) findings and/or orbital magnetic resonance imaging findings from baseline to 3, 6, 9, 12, 24, and 48 weeks. Regression was graded as follows: satisfactory when 90% and above of the baseline lesion volume and extension decreased, acceptable when 50 to 90%, mediocre when 30 to 50%, poor less than 30%.ResultsTwenty-four patients were included in this study. The mean age at presentation was 4 ± 1 week. Sixteen (71%) patients were females and 7 (29%) were males. The mean follow-up duration was 18 ± 3 months. Therapy was started for of 23/24 patients at 5 weeks old, of 1/24 started at 9 weeks of age. The median age was 5,16 weeks. Sixteen patients (66%) had satisfactory resolution between 3 and 6 weeks, 5 (20%) after 9 weeks, and 3 (12%) after 12 weeks. One patient (5%) had a mediocre response after 24 weeks. One patient withdrew from therapy because of hypoglycemia, which was successfully managed as an outpatient. No significant adverse reactions, such as bradycardia, hypotension, bronchospasm, or congestive heart failure, were detected in this cohort.ConclusionThis study indicates that the real-life use of oral propranolol for infantile hemangioma yields a high success rate with a lower morbidity than previously reported, particularly when managed by a proficient and multidisciplinary team.https://www.frontiersin.org/articles/10.3389/fopht.2025.1493171/fulloral propranololinfantile hemangiomasamblyopiaocular adnexalvascular tumor
spellingShingle Stefano Malvindi
Elena Sammarco
Andrea Elefante
Vittoria Lanni
Domenico Cicala
Francesco Esposito
Ciro Picardi
Adriana Iuliano
Dana Cohen
Giuseppe Mariniello
Antonella D’Aponte
Ciro Costagliola
Francesco Briganti
Diego Strianese
Real-life efficacy and safety of oral propranolol for ocular adnexal infantile hemangiomas: observational cohort study
Frontiers in Ophthalmology
oral propranolol
infantile hemangiomas
amblyopia
ocular adnexal
vascular tumor
title Real-life efficacy and safety of oral propranolol for ocular adnexal infantile hemangiomas: observational cohort study
title_full Real-life efficacy and safety of oral propranolol for ocular adnexal infantile hemangiomas: observational cohort study
title_fullStr Real-life efficacy and safety of oral propranolol for ocular adnexal infantile hemangiomas: observational cohort study
title_full_unstemmed Real-life efficacy and safety of oral propranolol for ocular adnexal infantile hemangiomas: observational cohort study
title_short Real-life efficacy and safety of oral propranolol for ocular adnexal infantile hemangiomas: observational cohort study
title_sort real life efficacy and safety of oral propranolol for ocular adnexal infantile hemangiomas observational cohort study
topic oral propranolol
infantile hemangiomas
amblyopia
ocular adnexal
vascular tumor
url https://www.frontiersin.org/articles/10.3389/fopht.2025.1493171/full
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