Abstract
Objectives
To study the efficacy and the long-term outcomes of treating micro and macrocystic orbital and/or adnexal lymphatic malformations (OA-LM) with protocol-based bleomycin sclerotherapy.
Methods
A retrospective interventional study of 69 eyes having OA-LM treated with non-image guided transcutaneous or transconjunctival bleomycin sclerotherapy (1IU/ml aqueous solution) between December 2014 and December 2018. Based on clinical regression, the outcomes were classified as excellent, good, fair and poor.
Results
The mean age at presentation was 20 ± 16 years (median 16; range 1 month to 70 years). The orbital-palpebral variant was the most common presentation, seen in 29 patients (42%). Microcystic morphology was seen in 34(49%), macrocystic in 22 (32%) and mixed cyst in 13 (19%) patients. Mean units of bleomycin injected per patient were 9 ± 8 IU (median 5.5 IU, range 1–38 IU). Mean number of treatment sessions required were 2 ± 1 (median 2, range 1–6). The response was excellent in 43 (62%), good in 12 (17%), fair in 9 (13%) and poor in 5 (7%) patients. These responses were comparable across the morphological subgroups (p = 0.24, chi-square test). Adverse reactions noted were inflammation in 11 eyes (16%) and peri-ocular pigmentation in 15 (22%). There was a sustained tumour regression over a mean follow-up duration of 3.5 years (median 3; range 1.5–5 years).
Conclusions
Seventy-nine percent of eyes with OA-LM showed a good outcome with transcutaneous and/or transconjunctival non-image guided bleomycin sclerotherapy with no serious adverse events. The results were promising over long-term follow-up.
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Acknowledgements
We acknowledge the support by Shobha Mocherla, PhD, Audio-Visual Producer, Communications, L V Prasad Eye Institute for proof reading of language and grammar throughout the text, tables and figures.
Funding
This study was funded by the Hyderabad Eye Research Foundation.
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TVD: conceptualization of the manuscript, data collection, data analysis and interpretation, manuscript drafting, critical revision and manuscript finalization. BKM: Data collection, analysis, and interpretation. SL: data collection, analysis and interpretation. DT, SK, SR, SM, AD, and AGK: review of manuscript.
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Dave, T.V., Madhuri, B.K., Laghmisetty, S. et al. Long term outcomes of transcutaneous non-image guided bleomycin sclerotherapy in orbital/adnexal lymphatic malformations: a protocol-based management in 69 eyes. Eye 36, 789–799 (2022). https://doi.org/10.1038/s41433-021-01527-9
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DOI: https://doi.org/10.1038/s41433-021-01527-9
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