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Capillary hemangioma of the eye
Last reviewed: 23.04.2024
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Capillary hemangioma of the eye is the most frequent tumor of orbit and periorbital in children. This hamartoma may be a small, isolated, clinically insignificant formation or may become large, disfigured and lead to visual impairment and systemic complications.
For the diagnosis of capillary hemangioma, the eye is basically sufficient for an examination. The formation can be superficial, subcutaneous, deep or combined with various defects and eye symptoms.
It usually appears in the perinatal period, but never at birth.
[Symptoms of capillary hemangioma of the eye
- Superficial "strawberry" nevus on the eyelids - a frequent sign.
- Subcutaneous hemangioma of the eyelid or anterior part of the orbit is visible through the skin covering with a dark blue or purple color.
- Frequent tumor localization is the upper anterior part of the orbit; can be accompanied by a dystopia.
- Deeply located tumor of the orbit causes exophthalmos without changing the color of the skin.
- Hemangiomatous formations of the eyelids and arches of the conjunctiva can usually serve as an important diagnostic feature.
- Large tumors can increase and change color towards a rich blue color with crying or physical strain and are never accompanied by pulsation or noise.
- In 25% of cases there are capillary hemangiomas in other parts of the body.
CT is required for deep-seated lesions, when the diagnosis can not be established upon examination. CT reveals a volume homogeneous soft-tissue formation in the anterior part of the orbit or outside the muscular cone, the posterior part of which is similar to the finger. The cavity of the orbit can be enlarged, but there is no erosion of the bone.
The course of the capillary hemangioma of the eye
Characteristic growth during the first year of life, followed by a gradual involution. Starting from 2 years. Complete resorption occurs by 4 years in 40% of cases and by 7 years - in 70%.
System Combinations
Children with large hemangiomas may suffer simultaneously:
- Heart failure.
- Kasabach-Meritt syndrome, characterized by thrombocytopenia, anemia and low rates of coagulation factors.
- The Moffuci syndrome, characterized by cutaneous hemangiomas, chondropathy of the hands, legs, long bones and their curvature.
What do need to examine?
How to examine?
Treatment of capillary hemangioma of the eye
Indications
- Amblyopia, more often secondary due to astigmatism and anisometropia.
- The compression of the optic nerve.
- Exposure to keratopathy.
- Pronounced cosmetic defect, necrosis or infection.
Methods of treatment of capillary hemangioma of the eye
- Injection of steroids (triamcinolone acetoide 40 mg with betamethasone 6 mg) is locally very effective in subcutaneous localization in the early active stage. Possible complications include retrograde forced entry of the solution into the central artery of the retina, depigmentation of the skin and necrosis, bleeding and atrophy of fatty tissue;
- Systemic administration of steroids daily for several weeks can also be effective, especially with an extensive orbital component;
- local resection with cauterization can reduce the volume of the pre-arranged, limited tumor, but usually it is used in late inactive stages;
- low-dose radiotherapy.