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Kinder- und Jugendmedizin 2018; 18(03): 161-167
DOI: 10.1055/s-0038-1660969
Augenheilkunde
Schattauer GmbH

Infantile Hämangiome im Lid- und Orbitabereich

Infantile hemangiomas of the eyelids and the orbit
I. Sterker
1   Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Leipzig
,
M. Weißer
2   Klinik für Kinderchirurgie, Universitätsklinikum Leipzig
› Author Affiliations
Further Information

Publication History

Eingereicht am: 28 December 2017

angenommen am: 22 February 2018

Publication Date:
05 June 2018 (online)

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Zusammenfassung

Infantile Hämangiome im Lid- und Orbitabereich können trotz ihres selbstlimitierenden natürlichen Verlaufs zu funktionellen Defiziten infolge einer Amblyopie oder Optikuskompression führen oder ein ästhetisch störendes Erscheinungsbild entwickeln und bedürfen dann einer Therapie.

Seit der „zufälligen” Entdeckung des Effektes von Propranolol auf infantile Hämangiome im Jahr 2008 wird diese Substanz zur Behandlung komplizierter Hämangiome eingesetzt, die ansonsten den Einsatz von Kortikosteroiden, Laser oder operativen Verfahren erfordert hätten. Propranolol systemisch ist derzeit bei komplizierten Hämangiomen der Lider und Orbita aufgrund des raschen und komplikationsarmen Therapieeffektes Therapie der ersten Wahl.

Dargestellt werden Pathogenese, Klassifikation, Indikation zur Therapie, Therapieoptionen sowie deren Effektivität für infantile Hämangiome im Lid- und Orbitabereich.

Weitere klinische Studien zur Optimierung von Dosierung, Behandlungsdauer und Art der Anwendung von Propranolol (lokal oder systemisch) sind jedoch weiterhin erforderlich, um den Regressionseffekt und die Regressionsrate weiter zu verbessern.

Summary

Despite the self-limiting natural course of infantile hemangiomas of the eyelids and orbit, effects of amblyopia, compression of the optic nerve, and impairment of the esthetic appearance may develop and in these cases therapy is necessary.

Since the serendipitous discovery of the effects of propranolol on infantile haemangioma in 2008, it has largely replaced the former standard treatments with corticosteroids, laser or surgical procedures. Propranolol is now the gold standard of therapy for complicated hemangiomas of the eyelids, and the orbit because of the prompt therapeutic effect and the less rate of complications.

This review discusses the pathogenesis, classification, indication of treatment, and treatment options and the treatment efficacy of propranolol for infantile hemangiomas of the eyelids and orbit.

Further clinical studies are necessary to optimize the dosage of propranolol, treatment period, and application modalities (oral or topical) and to improve the efficacy and rate of regression of hemangiomas.

Schlüsselwörter

Infantile Hämangiome - Lid- und Orbitabereich - Amblyopie - Propranolol

Keywords

Infantile hemangiomas - eyelids and orbit - amblyopia - propranolol
 

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