Management of orbital lymphangioma using intralesional injection of OK-432

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 visua l 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 co ntents. Visual acuity improved to 20/15, and the visual field defect and re striction 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 wit hout functional disturbance and scar in the facial skin. OK-432 may be usef ul for orbital lymphangioma, but further studies are still warranted to det ermine efficacy, complications, and the optimal dose for safe treatment.