Purpose

To review the published literature assessing the efficacy of β-blockers for the treatment of periocular hemangioma in infants.

Methods

Literature searches were conducted in May 2018 in PubMed with no date restrictions and limited to studies published in English and in the Cochrane Library database without any restrictions. The combined searches yielded 437 citations. Of these,16 articles were deemed appropriate for inclusion in this assessment and assigned a level of evidence rating by the panel methodologist.

Results

None of the 16 studies included in this assessment were rated level I, 3 were rated level II, and 13 were rated level III. The most common treatment regimen was 2 mg/kg daily oral propranolol, but intralesional and topical β-blockers were also used. Treatment effect was most often measured in terms of reduction in the size of the lesions, which occurred in the majority of patients. β-Blockers were consistently shown to reduce astigmatism, but this reduction was shown to be statistically significant in only 2 series. The effect of β-blockers on amblyopia was not adequately documented. β-Blockers were generally well tolerated and had mild side effects (fatigue, gastrointestinal upset/diarrhea, restlessness/sleep disturbances, minor wheezing, and cold extremities). Complications severe enough to require cessation of treatment occurred in only 2 patients out of a total of 229 who received β-blockers.

Conclusions

There is limited evidence to support the safety and efficacy of both topical and systemic β-blockers to promote regression of periocular hemangiomas. Additional research may confirm the best dosage and route of administration to maximize efficacy in reducing induced astigmatism and amblyopia associated with periocular hemangiomas while minimizing side effects.

中文翻译：

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使用β用于眼周血管瘤的治疗婴儿的β受体阻滞剂

目的

回顾评估β受体阻滞剂治疗婴儿眼周血管瘤疗效的公开文献。

方法

文献检索于2018年5月在PubMed中进行，没有日期限制，并且限于以英语发表的研究以及在Cochrane图书馆数据库中进行的研究，没有任何限制。总计搜索结果为437次被引用。其中，有16篇文章被认为适合纳入本评估，并由专家组方法学家指定了一定等级的证据。

结果

评估中包括的16项研究中，没有一项被评为I级，3项被评为II级，13项被评为III级。最常见的治疗方案是每天口服2 mg / kg普萘洛尔，但也使用病灶内和局部β受体阻滞剂。大多数情况下，通过减少病变的大小来衡量治疗效果。始终显示β受体阻滞剂可减少散光，但仅在2个系列中显示该减少具有统计学意义。没有充分证明β受体阻滞剂对弱视的作用。β-受体阻滞剂通常耐受良好，并具有轻度的副作用（疲劳，胃肠道不适/腹泻，躁动/睡眠障碍，轻微喘息和肢体寒冷）。

结论

仅有有限的证据支持局部和全身性β-受体阻滞剂促进眼周血管瘤消退的安全性和有效性。进一步的研究可能会确定最佳的剂量和给药途径，以最大程度地降低与眼周血管瘤相关的诱发散光和弱视的功效，同时最大程度地减少副作用。