Infantile hemangioma of the upper eyelid in one very and in two extremely preterm infants

Introduction. Infantile hemangiomas (IHs) are the most common vascular tumors of infancy. Their frequency increases with decreasing gestational age. Periorbital IHs (PIHs), although rare, have a high complication rate, with a substantial risk of impaired vision and aesthetic consequences. Thus, they are considered high-risk IHs and require treatment. In the available literature there is little information about the treatment of IHs in very and extremely preterm infants. Case report. We present three male infants (one very and two extremely prematurely born) with PIHs involving the upper eyelid. In all three cases IHs were solitary but with different subtypes according to soft-tissue depth (superficial; combined; deep). In none of the cases no additional congenital anomalies were found. An individualized approach to the management of each patient was applied. All infants were treated with oral propranolol, with careful monitoring for potential side effects and adjustment of treatment accordingly. Introduction of oral propranolol was carried out in a hospital setting, with a gradual increase of the drug dose, until the target dose is reached. Conclusion. In the case of PIH, an ophthalmologist is an inevitable part of the medical team. Very and extremely preterm infants are already under the supervision of an ophthalmologist due to mandatory screening for retinopathy of prematurity, but if they also have PIHs, monitoring must be particularly detailed and long-lasting.