Observation |

Deep Periocular Infantile Capillary Hemangiomas Responding to Topical Application of Timolol Maleate, 0.5%, Drops

Kanmin Xue, BA, MBBChir, PhD1; Göran Darius Hildebrand, MD, FRCS, FRCOphth1
[+] Author Affiliations
1Pediatric Ophthalmology Service, Prince Charles Eye Unit, King Edward VII Hospital, Windsor, and Royal Berkshire NHS Foundation Trust, Reading, England
JAMA Ophthalmol. 2013;131(9):1246-1248. doi:10.1001/jamaophthalmol.2013.4171.
Text Size: A A A
Published online


Oral propranolol hydrochloride is widely used as first-line therapy for periocular infantile capillary hemangiomas. Close monitoring is required as potentially serious adverse effects are well recognized. Recently, the topical β-antagonist timolol maleate has also been reported to be an effective treatment for superficial infantile hemangiomas (IHs). As a result, a general paradigm has emerged that topical timolol may be a good option for superficial IH, while systemic propranolol remains the treatment of choice for deep IH. We describe 2 infants with deep periocular IHs who have undergone successful primary monotherapy with topical timolol maleate, 0.5%, drops. In both cases, topical treatment alone led to near-complete involution of the IH, and the effect has been well sustained following tapering or cessation of treatment.

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Figure 1.
Case 1

A, A 7-week-old girl had a rapidly growing, deep left upper eyelid capillary hemangioma causing eyelid closure and obstruction of the visual axis. B, After 1 week of topical treatment with timolol maleate, 0.5%, the lesion became paler, shrunk, and no longer obstructed the visual axis. C, After 10 months of topical timolol treatment, the lesion showed almost complete involution associated with resolution of amblyopia. D, No sign of recurrence was seen 4 months after stopping topical timolol treatment.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.
Case 2

A, A 6-month-old infant had a deep right lower eyelid capillary hemangioma causing deformation of the nose and restriction of adduction in depression of the right eye. B, Eleven months after topical treatment with timolol maleate, 0.5%, the swelling and discoloration have almost completely resolved and the nose is no longer deviated to the left.

Graphic Jump Location




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles