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