Clincal Research Of Pingyangmycin As Treatment For Orbital Low-flow Venous Malformation

Objective: To investigate the efficacy and safety of intralesional injection ofpingyangmycin for low flow orbital or periorbital venous malformations and toaccumulate clinical experiences to guide the clinical practice.Methods and Materials: Clincal data on33consecutive patients (33eyes) with low-floworbital or periorbital venous malformations undergoing intralesional injection ofpingyangmycin in Ninth People’s Hospital Shanghai JiaoTong University School ofMedicine between2002-2013were retrospectively reviewed, and a non-comparativeinterventional case series were conducted in this study. Injections of1to5ml of1.5mg/mlPingyangmycin mixture were given. One to four injections were administered to eachpatient at an interval of6–8weeks. Clinical observations including the location of themalformation, age at initial treatment, number of injections, doses, duration of follow-up,reduction of lesion volume, overall appearance, blueness, thickness of the lesions wererecorded before and after treatment. Adverse events of intralesional injection ofpingyangmycin associated with therapy were recorded.Results: The ages of patients ranged between4and45years (23.8±11.2years). There were15(45.5%) male patients and18(54.5%) female patients. Follow-up duration ranged from2to48months (7.9±8.2months). All patients had venous malformations confined to theperiorbital or orbital area, among which15were right sided and18left sided. Seventeenpatients had upper or lower eyelid involvement; nine of these had conjunctivainvolvement; two glabella involvement; one inner canthus involvement, and four lesionswere located intraconally. Nineteen (57.6%) patients had superficial lesions, three haddeep lesions (9.1%), and eleven (33.3%) had combined lesions. Patients received anaverage of1.9±0.9intralesional injections of Pingyangmycin. The average pre-treatmentvolume was4.4cm3and post treatment1.0cm3(t=4.63, P <0.001), which showed adecrease of84.4%on average (range,28%to100%). Moderate to marked improvement ofthe lesion was noticed in94%of eyes (31/33), which is94%in superficial lesions,100%in deep lesions, and90.9%in combined lesions. We noticed a significant improvement inblue color and thickness on the basis of investigator score from clinical photographs takenpre and post treatment. None of the patients had recurrence. Adverse events were limitedto swelling of the conjunctiva and localized subcutaneous atrophy.Conclusions: In this series, the results of intralesional pingyangmycin injection for thetreatment of low flow orbital or periorbital venous malformations are encouraging andassociated with a low risk of adverse events. Objective: To investigate the efficacy and safety of intralesional injection ofpingyangmycin for low flow orbital or periorbital venous malformations and toaccumulate clinical experiences to guide the clinical practice.Methods and Materials: Clincal data on33consecutive patients (33eyes) with low-floworbital or periorbital venous malformations undergoing intralesional injection ofpingyangmycin in Ninth People’s Hospital Shanghai JiaoTong University School ofMedicine between2002-2013were retrospectively reviewed, and a non-comparativeinterventional case series were conducted in this study. Injections of1to5ml of1.5mg/mlPingyangmycin mixture were given. One to four injections were administered to eachpatient at an interval of6–8weeks. Clinical observations including the location of themalformation, age at initial treatment, number of injections, doses, duration of follow-up,reduction of lesion volume, overall appearance, blueness, thickness of the lesions wererecorded before and after treatment. Adverse events of intralesional injection ofpingyangmycin associated with therapy were recorded.Results:The ages of patients ranged between4and45years (23.8±11.2years). There were15 (45.5%) male patients and18(54.5%) female patients. Follow-up duration ranged from2to48months (7.9±8.2months). All patients had venous malformations confined to theperiorbital or orbital area, among which15were right sided and18left sided. Seventeenpatients had upper or lower eyelid involvement; nine of these had conjunctivainvolvement; two glabella involvement; one inner canthus involvement, and four lesionswere located intraconally. Nineteen (57.6%) patients had superficial lesions, three haddeep lesions (9.1%), and eleven (33.3%) had combined lesions. Patients received anaverage of1.9±0.9intralesional injections of Pingyangmycin. The average pre-treatmentvolume was4.4cm3and post treatment1.0cm3(t=4.63, P <0.001), which showed adecrease of84.4%on average (range,28%to100%). Moderate to marked improvement ofthe lesion was noticed in94%of eyes (31/33), which is94%in superficial lesions,100%in deep lesions, and90.9%in combined lesions. We noticed a significant improvement inblue color and thickness on the basis of investigator score from clinical photographs takenpre and post treatment. None of the patients had recurrence. Adverse events were limitedto swelling of the conjunctiva and localized subcutaneous atrophy.Conclusions: In this series, the results of intralesional pingyangmycin injection for thetreatment of low flow orbital or periorbital venous malformations are encouraging andassociated with a low risk of adverse events.