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   Table of Contents      
Year : 2013  |  Volume : 61  |  Issue : 7  |  Page : 368

Author's Reply

Division of Ophthalmology, Department of Surgical Sciences,Faculty of Health Sciences, Stellenbosch University, South Africa

Date of Web Publication30-Jul-2013

Correspondence Address:
David Meyer
Eye Clinic, 7th Floor, Tygerberg Academic Hospital, Francie van Zijl Drive, Tygerberg 7505
South Africa
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
Smit DP, Meyer D. Author's Reply. Indian J Ophthalmol 2013;61:368

How to cite this URL:
Smit DP, Meyer D. Author's Reply. Indian J Ophthalmol [serial online] 2013 [cited 2020 Jul 13];61:368. Available from: http://www.ijo.in/text.asp?2013/61/7/368/115795

Dear Editor,

We appreciate the interest shown by the author(s) in our article, [1] and thank them for their valuable comments. We would like to respond to the comments as follows:

Both patients in the case reports were referred to our eye clinic by colleagues in the plastic surgery department after the diagnosis of capillary hemangioma had already been confirmed, and intracranial extension excluded by them. We agree that clinical examination should be combined with other imaging modalities to confirm the diagnosis.

We discontinued treatment in both cases once we had achieved our goal of preventing stimulus deprivation amblyopia, since the posology reported by Luo and Zhao, [2],[3] had not yet been published and we were of the opinion that the remaining lesions would undergo further spontaneous resolution over time. We considered the use of a topical beta-blocker to expedite this process, [4] but did not have access to a suitable preparation. The information provided by Luo and Zhao, [2],[3] would indeed be very useful if we need to treat similar cases in future.

The reason for not using oral propranolol as first line therapy is simply because of timing. We administered the first intralesional bleomycin injection (IBI) on 13 June 2008, and the landmark article first describing the use of propranolol for the treatment of capillary hemangiomas only appeared after we had completed our research on the topic. [5] Publications in the ophthalmic literature regarding the use of oral propranolol appeared much later. [6],[7] We now also routinely use oral propranolol as first line therapy, but maintain that IBI does warrant consideration in patients with capillary hemangiomas, if the use of a beta-blocker is contraindicated for whatever reason.

  References Top

Smit DP, Meyer D. Intralesional bleomycin for the treatment of periocular capillary hemangiomas. Indian J Ophthalmol 2012;60:326-8.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
Luo QF, Zhao FY. The effects of Bleomycin A5 on infantile maxillofacial haemangioma. Head Face Med 2011;7:11.  Back to cited text no. 2
Luo Q, Zhao F. How to use bleomycin A5 for infantile maxillofacial haemangiomas: Clinical evaluation of 82 consecutive cases. J Craniomaxillofac Surg 2011;39:482-6.  Back to cited text no. 3
Guo S, Ni N. Topical treatment for capillary hemangioma of the eyelid using beta-blocker solution. Arch Ophthalmol 2010;128:255-6.  Back to cited text no. 4
Léauté-Labréze C, Dumas de la Roque E, Hubiche T, Boralevi F, Thambo JB, Taïeb A. Propranolol for severe hemangiomas of infancy. N Engl J Med 2008;358:2649-51.  Back to cited text no. 5
Fay A, Nguyen J, Jakobiec FA, Meyer-Junghaenel L, Waner M. Propranolol for isolated orbital infantile hemangioma. Arch Ophthalmol 2010;128:256-8.  Back to cited text no. 6
Taban M, Goldberg RA. Propranolol for orbital hemangioma. Ophthalmology 2010;117:195-195.e4.  Back to cited text no. 7


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