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. 2000 Jun;84(6):614–617. doi: 10.1136/bjo.84.6.614

Management of orbital lymphangioma using intralesional injection of OK-432

Y Suzuki 1, A Obana 1, Y Gohto 1, T Miki 1, H Otuka 1, Y Inoue 1
PMCID: PMC1723521  PMID: 10837387

Abstract

AIM—To treat orbital lymphangioma with an intralesional injection of OK-432 (group A Streptococcus pyogenes of human origin).
METHOD—A 14 year old boy had a right orbital cystic lymphangioma. The visual acuity in the eye was 20/28. In an initial treatment, 0.02 mg of OK-432, was injected into the tumour after aspiration of the fluid contents, but no effect was seen. The second treatment was performed with 0.04 mg of OK-432.
RESULT—4 months later, the lesion had totally shrunk to fibrous tissue. The side effects were fever, a local inflammatory reaction lasting 3 days, and increased intraocular pressure, which was managed by draining the fluid contents. Visual acuity improved to 20/15, and the visual field defect and restriction of eye movement seen before treatment disappeared. No recurrence was noted 1 year after treatment.
CONCLUSION—An intralesional injection of OK-432 shrunk the lymphangioma without functional disturbance and scar in the facial skin. OK-432 may be useful for orbital lymphangioma, but further studies are still warranted to determine efficacy, complications, and the optimal dose for safe treatment.



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Figure 1  .

Figure 1  

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The patient before treatment. Note the distinct proptosis and the dislocation of the right eyeball laterally and upward.

Figure 2  .

Figure 2  

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(A) T1 and T2 weighted images of a magnetic resonance image before treatment (horizontal section): note the high signals and septal structures inside. (B) T2 weighted images in sagittal section. A cystic tumour continues to the lower eyelid.

Figure 3  .

Figure 3  

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Swelling of the eyelid, redness, and conjunctival oedema are seen 7 days after the second intralesional injection of OK-432.

Figure 4  .

Figure 4  

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T1 and T2 weighted images from a magnetic resonance image done 4 months after the second intralesional injection of OK-432 demonstrate that the tumour had shrunk considerably and its aqueous component had disappeared.

Figure 5  .

Figure 5  

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The patient 12 months after the second injection of OK-432. There was no tumour recurrence.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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