{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T08:17:52Z","timestamp":1788164272026,"version":"build-2803163510"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate the long-term outcomes of non-image-guided intralesional injection of bleomycin to treat patients with orbital-adnexal lymphatic malformations (OA-LM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Study design<\/jats:italic>\n                      : Retrospective study.\n                      <jats:italic toggle=\"yes\">Setting:<\/jats:italic>\n                      Single center, tertiary care referral institute.\n                      <jats:italic toggle=\"yes\">Patient population\/selection:<\/jats:italic>\n                      All consecutive patients of OA-LM (treatment-na\u00efve or previously treated) from January 2019 to December 2023 (5 years).\n                      <jats:italic toggle=\"yes\">Intervention:<\/jats:italic>\n                      We used lignocaine 2% to reconstitute bleomycin, which was then injected into the core of the OA-LM lesion as a sclerosant. We planned a minimum of three injections per patient at 1-month intervals; any additional injections were planned after clinical and radiological evaluation.\n                      <jats:italic toggle=\"yes\">Outcome measures:<\/jats:italic>\n                      Defined according to the clinical regression of OA-LMs as excellent (&gt;75%), good (&gt;50\u201375%), fair (&gt;25\u201350%), and poor (&lt;25%). A minimum follow-up of 1 year after the last injection was ensured.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All 51 cases (39 males, 76.5%, 2 transgender people) had unilateral involvement, and the mean age at presentation was 27.5 years. The majority were of microcystic variant (n = 29, 60.4%), macrocystic variant (9, 18.75%), and mixed variant (n = 13, 28.1%). Twenty-two (43.14%) were previously treated with oral steroids (n = 18), intralesional steroids (n = 12), intralesional 5-fluorouracil (n = 5), and surgical excision (n = 9) (overlapping numbers). At a mean follow-up of 1.5 years, excellent outcomes were noted in 18 (35.3%), good in 20 (39.2%), fair in 6 (11.8%), and poor in 7 (13.7%) patients. Nine patients (17.6%) had transient hyperpigmentation of the overlying skin, while none had systemic complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Non-image-guided, protocol-based bleomycin mono-sclerotherapy injection is a safe and effective procedure for both treatment-na\u00efve and previously treated OA-LMs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_3068_25","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:00:10Z","timestamp":1779357610000},"page":"1366-1372","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Non-image-guided injection of bleomycin to treat orbital-adnexal lymphatic malformations: Effect of lesion morphology and previous treatment on outcomes"],"prefix":"10.4103","volume":"74","author":[{"given":"Manpreet","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazia","family":"Anjum","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Sciences, Vijaypur, Jammu, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manpreet","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditi Mehta","family":"Grewal","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manu","family":"Saini","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meenakshi","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjula","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Advanced 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