Haemangioma
Congenital, fast growing vessels of the
orbit and the eyelid(s).
Congenital haemangioma are embryonic
tumours.
Approx. 2-3 % of all neonates and approx.
10 % of all premature infants have haemangioma.
Haemangioma are mostly quite small at birth, but about
10% of these haemangioma grow significantly within the
first year of life. 90 % of these cases lead to a
spontaneous regression of the abnormal vessels until the
end of the second year of life and a complete healing
takes place.
Histological there are different types of
hemangioma with different clinical progression : e.g.
capillary hemangioma, cavernous hemangioma etc.. They
can occur at all vascularized vital parts.
If they occur in the region of the eyelids or the
orbits, they are discovered by chance during other
examinations or if their parts range to the skin of the
lids.
In dependence of their growth and their clinical
progress, they ought to be controlled carefully and
frequently. Controls of the progress can be made by
ultrasound.
If the localisation is deeper within the
orbit or if one has to decide whether surgery is
necessary, a MRI with contrast agent is helpful. If
there is not a spontaneous regression or if clinical or
functional deficits appear, a therapy should be started
instantaneously before irreversible damages occur.
The following complication of hemagioma
of the eyelids and of the orbit postulates a direct
therapy :
-
Increasing ptosis with restriction of
the field of view
-
Increasing amblyopia, e.g. by
choroideal folds
-
Exophthalmus (protrusion of the eye out
of the orbit)
-
Diplopic images by restriction of
motility of the respective eye
-
Ocular hypertension (glaucoma)
-
Etc.
The aim is not to lose track of
hemangioma of the lids and the orbit during their growth
phase, for being able to intervene early if
complications are possible.
The different possibilities of therapy
have to be chosen in dependence of localisation, depth
and complications :
All possible alternatives should be
weighed up carefully, depending on the constellation of
the clinical findings and the patient. The therapy
should be performed at a specialized (oculoplastic)
centre at the right time.
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