Ophthalmic Pyogenic Granulomas Treated With Topical Timolol—Clinical Features of 17 Cases

Purpose: Topical timolol has been increasingly demonstrated to be an effective treatment for pyogenic granulomas (PG). The authors review the treatment outcomes of 17 patients with ocular PG treated with topical timolol. Methods: Retrospective interventional study of 17 patients with ocular PGs treated with timolol 0.5% solution. Patient demographics, clinical features, treatment response, and recurrence were noted. Results: Nine females and 8 males with a mean age of 23 years (range, 3–67 years) were included. Mean duration of disease prior to treatment was 3.81 months (range, 0.25–11 months). Etiologies included chalazia (12 cases, 71%), postsurgical (4, 24%) and trauma (1, 6%). Five patients (29%) had treatment with topical steroids prior to presentation. Fifteen patients (88%) had PG located on the palpebral conjunctiva and 2 (12%) involving the bulbar conjunctiva. Mean lesion size was 5.06 × 6.06 mm (range, 3–8 × 3–18 mm). Fifteen patients (88%) had complete lesion resolution with a mean treatment duration of 3.07 weeks (range, 2–5 weeks) and no adverse events or recurrences with a mean follow up of 9.47 months (range, 6–27 months). Two patients (12%) underwent lesion excision after 6 weeks of timolol failed to yield resolution. Conclusion: Topical timolol appears to be a well-tolerated nonsurgical treatment of ocular PG in both children and adults. Clinicians may wish to consider topical timolol to treat PG as opposed to topical steroids, given the inherent risk of steroid response ocular hypertension and the difficulty to measure intraocular pressure in younger children who require general anesthesia for excision. Accepted for publication February 15, 2018. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Roman Shinder, M.D., F.A.C.S., Department of Ophthalmology, SUNY Downstate Medical Center, 451 Clarkson Ave, E bldg, 8th Fl, Suite C, Brooklyn, NY 11203. E-mail: shinder.roman@gmail.com © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.