Evaluation and management of periocular capillary hemangioma: a Review

ABSTRACT

To review the salient features of periocular capillary hemangioma, provide the ophthalmologist with clinical, diagnostic and histological features characteristic of the tumor and discuss various methods of management. Literature review of periocular capillary hemangioma, diagnostic evaluation with emphasis on treatment through the presentation of illustrative clinical cases. Capillary hemangioma is the most common benign vascular tumour found on the head and neck area including eyelids and orbit. The lesion typically manifests within the first few weeks of life, grows rapidly in the first year during the proliferative phase, then invariably and slowly regresses over the next 4 to 5 years during the patients, however, the functional defects in the form of amblyopia, squint, facial disfigurement and rarely optic atrophy may persist long after complete resolution of the tumor. the diagnosis of capillary hemangioma requires a combination of clinical and imaging studies such as ultrasonography, computerized tomography, magnetic resonance imaging, and angiography in selected cases. With the advent of less invasive diagnostic techniques, the need for biopsy in capillary hemangiomas has decreased. Nevertheless, it should be differentiated from other periocular tumour such as rhabdomyosarcoma, lymphangioma, chloroma, neuroblastoma, orbital cyst, and orbital cellulitis. Treatment is indicated to prevent amblyopia or cosmetic disfigurement. If indicated, intra-lesional corticosteroids may be used to enhance resolution of the tumor. Other forms of treatment tried with variable success include systemic and topical corticosteroids, radiation, surgical excision and intravenous embolization of the tumor. In recent years, laser ablation of the tumor has been found to be effective in some cases. Interferon-u' has been utilized effectively in cases of capillary hemangiomas that are refractory to other forms of therapy. Early treatment of amblyopia is essential to restore good vision in the affected eye. Eyelid and orbital capillary hemangiomas are treatable vascular lesions. Ophthalmologists should be aware of the ocular complicationns of this tumor. Early recognition and timely diagnosis and treatment may prevent amblyopia and cosmetic disfigurement