{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T10:52:54Z","timestamp":1753354374315},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Infantile haemangiomas (IHs) are the most common benign tumours of the eyelid and orbits in infancy. Beta-blockers, in the form of oral propranolol, have become first-line treatment in severe cases with functionally significant or disfiguring IH. However, adverse drug reactions of oral propranolol in infants are reported in 1 in 11 and serious or potentially life-threatening systemic side effects in 1 in 38, including dyspnoea, hypotension, hyperkalaemia, hypoglycaemia, and cyanosis, therefore requiring careful and close monitoring during the course of systemic treatment. More recently, two large meta-analyses have shown topical beta-blockers, such as timolol maleate 0.5%, to be as effective as oral propranolol in superficial IH, but with no or significantly fewer adverse effects, and have advocated that topical beta-blockers replace oral propranolol as the first-line treatment of superficial IH. We have previously reported the therapeutic response of deep periocular IH to primary topical timolol maleate 0.5% monotherapy. Here we also describe the first successful treatments of large orbital IHs with primary topical timolol maleate 0.5% monotherapy in four infants, resulting in immediate cessation of progression and rapid clinical improvement or resolution in all cases. No adverse effects and no recurrence during long-term follow-up of up to 2.5 years after cessation were seen in any of the patients treated with topical timolol maleate 0.5%.<\/jats:p>","DOI":"10.1055\/a-1645-1665","type":"journal-article","created":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T23:30:53Z","timestamp":1634599853000},"page":"1069-1076","source":"Crossref","is-referenced-by-count":5,"title":["Topical Timolol for Infantile Haemangioma of the Orbit"],"prefix":"10.1055","volume":"238","author":[{"given":"G\u00f6ran Darius","family":"Hildebrand","sequence":"additional","affiliation":[{"name":"Oxford Eye Hospital, The John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zuzana","family":"Sipkova","sequence":"additional","affiliation":[{"name":"Oxford Eye Hospital, The John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,10,18]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1055\/s-0040-1722633","article-title":"Typical Orbital Pathologies: Hemangioma","volume":"82","author":"C M Low","year":"2021","journal-title":"J Neurol Surg B Skull Base"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jaad.2015.08.024","article-title":"Increasing incidence of infantile hemangiomas over the past 35 years: Correlation with decreasing gestational age at birth and birth weight","volume":"74","author":"K R Anderson","year":"2016","journal-title":"J Am Acad Dermatol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1111\/j.1365-3016.2011.01214.x","article-title":"The prevalence and risk factors of infantile haemangiomas: a case-control study in the Dutch population","volume":"26","author":"M J Hoornweg","year":"2012","journal-title":"Paediatr Perinat Epidemiol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1001\/jama.2015.13969","article-title":"Safety of propranolol therapy for severe infantile hemangioma","volume":"315","author":"S Prey","year":"2016","journal-title":"JAMA"},{"key":"ref5","first-page":"3461","volume-title":"Chapter 669. Vascular Disorders","author":"K Martin","year":"2020"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"2649","DOI":"10.1056\/NEJMc0708819","article-title":"Propranolol for severe hemangiomas of infancy","volume":"358","author":"C L\u00e9aut\u00e9-Labr\u00e8ze","year":"2008","journal-title":"N Engl J Med"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1001\/archophthalmol.2009.370","article-title":"Topical treatment for capillary hemangioma of the eyelid using beta-blocker solution","volume":"128","author":"S Guo","year":"2010","journal-title":"Arch Ophthalmol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1111\/bcp.14196","article-title":"The effectiveness and safety of topical \u03b2-receptor blocker in treating superficial infantile haemangiomas: A meta-analysis including 20 studies","volume":"86","author":"Z Lin","year":"2020","journal-title":"Br J Clin 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