Intralesional Bleomycin for Orbital Lymphatic Malformations: Comparison of Clinical Versus Radiologic Regression by Volumetric Analysis.
Journal
Ophthalmic plastic and reconstructive surgery
ISSN: 1537-2677
Titre abrégé: Ophthalmic Plast Reconstr Surg
Pays: United States
ID NLM: 8508431
Informations de publication
Date de publication:
Historique:
pubmed:
26
9
2020
medline:
25
5
2021
entrez:
25
9
2020
Statut:
ppublish
Résumé
The aim of the study was to investigate the clinical resolution versus radiologic regression of orbital lymphatic malformations (LMs) following treatment with intralesional bleomycin sulfate sclerotherapy. A retrospective interventional study of 24 eyes with orbital LMs treated with nonimage-guided bleomycin sclerotherapy. The clinical and radiologic outcomes were classified as excellent, good, fair, and poor. Regression was assessed clinically and by radiologic volumetrics. Mean age at presentation was 17 ± 18 years (median 11, range 5 months to 70 years). Lesion morphology was microcystic in 11 (46%), macrocystic in 8 (34%), and mixed in 5 (21%) eyes. Mean units of bleomycin injected per session were 4 ± 2 IU (median 5 IU, range 1-6 IU). Mean number of treatment sessions required was 2 ± 1 (median 2, range 1-6). Cumulative units of bleomycin injected were 11 ± 9 (median 9, range 1-38 IU). The clinical response was excellent in 19 (79%), good in 4 (17%), and fair in 1 (4%). The mean preoperative and postoperative lesion volumes were 7 ± 4 cm3 and 0.8 ± 1.2 cm3, respectively (p < 0.0001, 95% CI, -7.89 to -4.51). Radiologic resolution of LM was excellent in 6 (25%), good in 8 (33%), fair in 7 (29%), and poor in 3 (13%) eyes. Spearman's rank correlation coefficient for correlation between clinical and radiologic grading was 0.51 (p = 0.01, 95% CI, 0.13-0.75%). There was a sustained tumor resolution without recurrence over a mean follow-up duration was 2 years (median 18 months; range 12-60 months). Bleomycin sclerotherapy for orbital LMs gives an excellent to good clinical response in 93%. However, a parallel radiologic regression is seen only in 58%. The endpoint to assess response should be clinical. Treatment till complete radiologic resolution may not be necessary.
Identifiants
pubmed: 32976330
pii: 00002341-202105001-00019
doi: 10.1097/IOP.0000000000001837
doi:
Substances chimiques
Sclerosing Solutions
0
Bleomycin
11056-06-7
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
S85-S91Informations de copyright
Copyright © 2021 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.
Déclaration de conflit d'intérêts
The authors have no financial or conflicts of interest to disclose.
Références
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