EFFICACY OF INTRALESIONAL BLEOMYCIN IN TREATMENT OF ORBITAL LYMPHANGIOMA
Author: Sindhuja Murugesan
Base Hospital / Institution: Trinity Eye Hospital, Coimbatore
ePoster presentation
Abstract ID: 24-181
Purpose
To study the effectiveness of intralesional bleomycin injection in orbital lymphangiomas
Methods
16 patients diagnosed with orbital lymphangiomas were included in this prospective study. All of them received intralesional bleomycin injection at a dose of 0.5mg/kg body weight (maximum 15mg) along with 2% lignocaine. The volume injected into the lesion was proportional to the volume of the aspirate from the lesion (preferably 20% of the aspirate) but did not exceed 5 ml at a session. For deep intraconal lesions ultrasound guided injection was given .Patients who required repeat injections were based on the documentation of serial clinical and radiological response to treatment. Repeat injections were given once in every 4 weeks. Patients who had hypersensitivity to bleomycin, impaired renal function test, pulmonary problems, pregnant or lactating women, and patients who lost to follow-up were excluded from this study.
Results
In our study out of the total 16 patients, 10 were females (62%) and 6 were males (38%). Five patients were in the paediatric group (< 16 years of age). All patients had unilateral presentation. Proptosis was the most common symptom (56%), followed by lid swelling (44%). The number of bleomycin injections ranged from 2 to 4, 8 patients (50%) had a complete resolution after 2 injections and 3 patients (19%) required 4 injections for satisfactory outcome. Two patients (12%) after 3 injections resolution was noted but at follow-up at 6 months recurrence was noted. Rest three patients (19%) after giving the maximum cumulative dose no resolution was noted clinically or radiologically, hence debulking or complete surgical excision was performed.
Conclusion
Intralesional bleomycin therapy is an effective and safe method of treatment of orbital lymphangioma without any significant ophthalmic or systemic side effects. It is a good alternative to surgical excision where it is not possible to remove the entire mass, and the patient is also concerned about cosmesis. It can also be used as an adjunct therapy to surgical debulking, where continuous negative pressure prevents chances of recurrence.
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