Effects of oral propranolol on a juxtapapillary capillary hemangioma: a single-subject pilot study.

Oral propranolol hydrochloride has been proven effective in treating infantile hemangiomas, and its potential efficacy in choroidal hemangiomas has been suggested. A 57-year-old woman with a juxtapapillary capillary hemangioma was treated with oral propranolol at Nagoya Medical Center in Japan in 2012. Although the condition of this patient partially improved, oral propranolol did not appear to have a critical therapeutic effect. To the authors' knowledge, this is the first pilot study to describe a case in which oral propranolol was used as a therapeutic approach for a retinal hemangioma.

Effects of oral propranolol on circumscribed choroidal hemangioma: a pilot study.

IMPORTANCE: Oral propranolol hydrochloride treatment has been proven effective for infantile hemangiomas. To our knowledge, this study is the first to report multiple cases in which oral propranolol therapy was used for patients with circumscribed choroidal hemangioma. OBSERVATIONS: Five patients with circumscribed choroidal hemangioma were treated at Nagoya Medical Center, Nagoya, Japan, from 2011 to 2012. Oral propranolol hydrochloride was initiated at 10 mg 3 times a day and was increased monthly by 30 mg/d until the desired effects were observed. The mean (SD) height of the tumor (based on the B-mode at the end of the study) was 84.5% (13.6%) relative to the initial height. Similarly, the mean (SD) tumor area (based on indocyanine green angiography) was 94.2% (6.0%), the mean (SD) visual acuity was 0.04 (0.21) logMAR, and the mean (SD) Humphrey visual field mean deviation was -0.98 (1.1) dB. In 3 patients with macular edema, the mean (SD) foveal thickness (measured with optical coherence tomography) was 114.0% (13.9%). CONCLUSIONS AND RELEVANCE: Although oral propranolol therapy may partially improve the condition of patients with circumscribed choroidal hemangioma, it does not seem to have a critical therapeutic effect, at least at blood concentrations lower than 50 to 100 ng/mL. TRIAL REGISTRATION: umin.ac.jp/ctr Identifier: UMIN000006623.

[The effect of stellate ganglion block on prolonged post-operative ocular pain].

PURPOSE: There are cases when ocular pain persists long after ocular surgery and can not be reduced by anti-inflammatory drugs. Our purpose was to evaluate the effect of stellate ganglion block(SGB) on such prolonged post-operative ocular pain. METHOD: The subjects were 35 patients. Divided into two groups. One we called the nociceptive pain group, containing 29 cases in which the trigeminal nerve in the orbit or passing through it was intact. The other we called the neuropathic pain group, containing 6 cases in which pain accompanied paralysis of the trigeminal nerve. SGB was performed two times per week. SGB was deemed effective when pain was reduced markedly and the administration of anti-inflammatory drugs became almost unnecessary. RESULTS: SGB was 96.6% effective in the nociceptive pain cases with the SGB performed an average of 5.9 times. On the other hand, in the neuropathic pain group, even though SGB was performed an average of 52.6 times it was only 66.7% effective. CONCLUSIONS: SGB may be useful for the treatment of prolonged post-operative ocular pain, but the elimination of neuropathic pain is more difficult than the elimination of nociceptive pain.