Botulinum Toxin in Ophthalmology

Dutton, Jonathan J.; Fowler, Amy M.

doi:10.1016/j.survophthal.2006.10.003

Cited by 134 publications

(124 citation statements)

References 142 publications

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“…Our study also confirms results of other studies showing that botulinum toxin is a highly effective temporary treatment for EN, with few complications and no adverse effects on the results of surgical EN repair. 39,45,59 The clinical reestablishment of muscle function after BoNT-A injections requires repeated injections over long periods. 49,50 The onset of resistance to botulinum toxin over time may be due to the immunological properties of the toxin that lead to the stimulation of antibody production, thus rendering further treatments ineffective.…”

Section: Discussionmentioning

confidence: 99%

“…Although neurosurgical treatment is available, the potential complications and relatively high recurrence rate have made botulinum toxin A the preferred symptomatic treatment for HFS. [34][35][36][37][38][39] As HFS rarely remits spontaneously, 40 most patients need to continue BoNT-A treatment for many years, if not for the rest of their lives. The long-term efficacy and safety of BoNT-A are, therefore, increasingly important questions.…”

Section: Introductionmentioning

confidence: 99%

“…Botulinum toxin is a highly effective temporary EN treatment with few complications and no adverse effects on the results of surgical EN repair. 39 Treatment of blepharospasm and HFS with BoNT-A has been found to alleviate symptoms and enhance quality of life. 5,46 Whereas most patients show long-term clinical improvement with repeated injections, however, some eventually stop responding and others fail to respond at all.…”

Section: Introductionmentioning

confidence: 99%

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Long-term efficacy of botulinum toxin A for treatment of blepharospasm, hemifacial spasm, and spastic entropion: a multicentre study using two drug-dose escalation indexes

Cillino

Raimondi

Guépratte

et al. 2009

Eye

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Purpose To investigate the long-term effectiveness and safety of botulinum neurotoxin A (BoNT-A) treatment in patients with blepharospasm (BEB), hemifacial spasm (HFS), and entropion (EN) and to use for the first time two modified indexes, 'botulin toxin escalation index-U' (BEI-U) and 'botulin toxin escalation index percentage' (BEI-%), in the dose-escalation evaluation. Methods All patients in this multicentre study were followed for at least 10 years and main outcomes were clinical efficacy, duration of relief, BEI-U and BEI-%, and frequency of adverse events. Results BEB, HFS, and EN patients received a mean BoNT-A dose with a significant intergroup difference (Po0.0005, respectively). The mean ( ± SD) effect duration was statistically different (P ¼ 0.009) among three patient groups. Regarding the BoNT-A escalation indexes, the mean ( ± SD) values of BEI-U and BEI-% were statistically different (P ¼ 0.035 and 0.047, respectively) among the three groups. In BEB patients, the BEI-% was significantly increased in younger compared with older patients (P ¼ 0.008). The most frequent adverse events were upper lid ptosis, diplopia, ecchymosis, and localized bruising. Conclusions This long-term multicentre study supports a high efficacy and good safety profile of BoNT-A for treatment of BEB, HFS, and EN. The BEI indexes indicate a significantly greater BoNT-A-dose escalation for BEB patients compared with HFS or EN patients and a significantly greater BEI-% in younger vs older BEB patients. These results confirm a greater efficacy in the elderly and provide a framework for long-term studies with a more flexible and reliable evaluation of drug-dose escalation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-term efficacy of botulinum toxin A for treatment of blepharospasm, hemifacial spasm, and spastic entropion: a multicentre study using two drug-dose escalation indexes

Cillino

Raimondi

Guépratte

et al. 2009

Eye

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“…Scott et al, reported an onset of clinical effect after 16 days of bupivacaine intramuscular injection (11) . Botulinum toxin A has a peak of action between 1 to 2 weeks after injection and will last until an average of 3 months (16) . That difference in time of action could explain the variability on some measurements, such as for patients 2, 3, 4 on the 60day visit.…”

Section: Discussionmentioning

confidence: 99%

Bupivacaine and botulinum toxin to treat comitant strabismus

Höpker¹,

Zaupa²,

Filho³

et al. 2012

Arq. Bras. Oftalmol.

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Purpose: To evaluate the change in ocular motility and muscle thickness measured with ultrasonography after intramuscular injection of bupivacaine and botulinum toxin A. Methods: Eight patients (five female) were enrolled to measure ocular motility prior and 1, 7, 30 and 180 days after one injection of 2 ml of 1.5% bupivacaine and 2.5 U of botulinum toxin A in agonist and antagonist muscles, respectively, of eight amblyopic eyes. Muscle thickness was measured prior and on days 1, 7 and 30 after injection using 10MHz ultrasonography (eyelid technique). Results: Mean change in alignment was 10 prism diopters after 180 days (n=6). An average increase of 1.01 mm in muscle thickness was observed after 30 days of bupivacaine injection and 0.28 mm increase was observed after botulinum toxin A injection, as measured by ultrasonography. Lateral rectus muscles injected with bupivacaine had a mean increase of 1.5 mm in muscle thickness. Conclusion: In this study, a change in ocular motility was observed after 180 days of intramuscular injection of bupivacaine and botulinum toxin in horizontal extraocular muscles. Overall, there was an increase of muscle thickness in both botulinum toxinum A and bupivacaine injected muscles after 30 days of injection when measured by ultrasonography. This change was more pronounced on lateral rectus muscles after bupivacaine injection.

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“…A via final da ação da toxina é impedir a liberação da acetilcolina na junção neuromuscular dos músculos estriados produzindo, assim, uma denervação química e, conseqüentemente, paralisia muscular (2) . Nas últimas três décadas, a toxina botulínica tem sido empregada para fins terapêuticos em inúmeras afecções (3) . A toxina botulínica do tipo A foi aprovada primeiramente em 1989 para o uso em estrabismo, blefaroespasmo e espasmo hemifacial.…”

Section: Resumo Introduçãounclassified

Efeitos adversos associados à aplicação de toxina botulínica na face: revisão sistemática com meta-análise

Zagui¹,

Matayoshi²,

Moura³

2008

Arq. Bras. Oftalmol.

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Os autores não têm interesse ou apoio financeiro relacionado ao objeto de estudo deste manuscrito. Objetivo: Verificar a ocorrência dos efeitos adversos relacionados ao uso da toxina botulínica na face, por meio de revisão sistemática, usando metaanálise. Métodos: Foi realizada pesquisa eletrônica de artigos publicados no MEDLINE e Cochrane Library até setembro de 2007. A ocorrência dos efeitos adversos foi verificada pela freqüência relativa para os relatos de casos e do risco relativo para os estudos randomizados. A heterogeneidade foi avaliada pelo teste Q e pelo índice I 2 . Foi utilizado o teste de significância de Egger para identificar viés de publicação e a análise de sensibilidade para verificar o efeito dos viéses de publicação. Resultados: Oito estudos randomizados e treze relatos de casos preencheram os critérios de inclusão. Na revisão sistemática dos relatos de casos, 1.003 pacientes foram estudados, dos quais 182 (18,14%) apresentaram efeitos adversos. O efeito adverso mais freqüente foi a ptose palpebral ocorrendo em 34 (3,39%) pacientes dos relatos de casos. Na meta-análise dos estudos randomizados, o risco relativo global para os efeitos adversos como cefaléia, ptose palpebral, reação local e infecção foi 1,07, 3,25, 0,99 e 0,94, respectivamente. Para todas as comparações, o valor de P foi maior que 0,05. Conclusão: O efeito adverso mais freqüente e que apresentou o maior risco relativo relacionado ao uso da toxina botulínica na face foi a ptose palpebral. A padronização dos efeitos adversos relatados é necessária a fim de melhor estabelecer as características dos mesmos. Roberta Melissa Benetti Zagui RESUMO INTRODUÇÃOToxina botulínica é uma exotoxina produzida pelo Clostridium botulinum, uma bactéria Gram-positiva e anaeróbica. Existem oito sorotipos de bactérias (A, B, C alpha, C beta, D, E, F e G) que produzem sete exotoxinas distintas; o tipo A, B e E são os mais comumente associados ao botulismo em humanos (1) . A via final da ação da toxina é impedir a liberação da acetilcolina na junção neuromuscular dos músculos estriados produzindo, assim, uma denervação química e, conseqüentemente, paralisia muscular (2) . Nas últimas três décadas, a toxina botulínica tem sido empregada para fins terapêuticos em inúmeras afecções (3) . A toxina botulínica do tipo A foi aprovada primeiramente em 1989 para o uso em estrabismo, blefaroespasmo e espasmo hemifacial. Em seguida, os tipos A e B foram aprovados para

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Botulinum Toxin in Ophthalmology

Cited by 134 publications

References 142 publications

Long-term efficacy of botulinum toxin A for treatment of blepharospasm, hemifacial spasm, and spastic entropion: a multicentre study using two drug-dose escalation indexes

Long-term efficacy of botulinum toxin A for treatment of blepharospasm, hemifacial spasm, and spastic entropion: a multicentre study using two drug-dose escalation indexes

Bupivacaine and botulinum toxin to treat comitant strabismus

Efeitos adversos associados à aplicação de toxina botulínica na face: revisão sistemática com meta-análise

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