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Secondary Congenital Glaucoma Associated With Retro-orbital Infantile Hemangioma

A Masquerade Syndrome

Ramtohul, Prithvi; Beylerian, Marie; Dambricourt, Loic; Matonti, Frédéric, MD PhD; Denis, Danièle, MD, PhD

doi: 10.1097/IJG.0000000000001227
Online Articles: Case Report/Small Case Series
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Purpose: The main purpose of this study was to describe a unique case of retro-orbital infantile hemangioma (IH) simulating a congenital glaucoma requiring prompt management with systemic propranolol.

Study Design: This was a case report.

Results: A 2-month-old white female was referred to our department of ophthalmology for progressive, unilateral protrusion of the left eye associated with epiphora. Clinical examination was suggestive of congenital glaucoma, as evidenced by high intraocular pressure, optic disc cup, increased corneal diameter, and axial length. The left eye proptosis was measured at 4 mm with the Hertel exophthalmometer. Cycloplegic refraction discloses high degree of astigmatism in the left eye. A cerebral and orbital magnetic resonance imaging revealed an intraconal vascular mass evocative of orbital IH.

Oral propranolol was initiated and resulted in a rapid radiologic reduction of the IH. Concomitantly, the notable finding was the reversal of congenital glaucoma parameters without the need of surgery.

Conclusions: To the best of our knowledge, this is the first observation of a secondary congenital glaucoma reversal with oral propranolol used for orbital IH management.

University Hospital Nord, Chemin des Bourrely, Marseille, France

Declarations: Ethics approval and consent to participate: applicable. Ethical approval was not required as this manuscript presents a case study. It was performed in accordance with the tenets of the Declaration of Helsinki.

Consent for publication: applicable. The parents gave written permission. This report does not contain any personal information that could lead to the identification of the patient.

Availability of data and materials: applicable. All data generated or analyzed during the current study are included in this published article.

P.R.: wrote the article. L.D., M.B., F.M., and D.D.: performed examinations under general anesthesia and clinical follow-up.

Disclosure: The authors declare no conflict of interest.

Reprints: Prithvi Ramtohul, University Hospital Nord, 13015 Marseille, France (e-mail: pramtohul@free.fr).

Received December 26, 2018

Accepted February 7, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.