Botulinum Toxin Injection for the Treatment of Strabismus

Binenbaum, Gil; Chang, Melinda Y.; Heidary, Gena; Morrison, David G.; Trivedi, Rupal H.; Galvin, Jennifer A.; Pineles, Stacy L.

doi:10.1016/j.ophtha.2021.05.009

Cited by 13 publications

(6 citation statements)

References 28 publications

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“…Botulinum toxin is currently the main treatment for some ophthalmological diseases, such as some types of strabismus [2,3] and facial dystonia. Facial dystonia comprises various diseases, such as essential blepharospasm or hemifacial spasm [4][5][6][7], characterized by a disproportionate tonic contraction of the orbicularis oculi that causes involuntary eyelid closure.…”

Section: Introductionmentioning

confidence: 99%

“…Botulinum toxin is a neurotoxin, a highly specific potent neuromuscular inhibitor that produces temporary chemical denervation by blocking the release of acetylcholine in the motor plaque [ 1 , 2 ]. Previous studies have documented that the effect of the neurotoxin begins a few days after the injection, peaks at 15–20 days disappears progressively at 3–5 months [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Effects of the periocular botulinum toxin on the ocular surface and anterior chamber: a prospective study in patients with hemifacial spasm and blepharospasm

et al. 2023

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Purpose To analyze using Pentacam®, the corneal and anterior chamber changes following periocular botulinum toxin injection in patients with facial dystonia. Methods Prospective study that included patients with facial dystonia that were going to receive a periocular botulinum toxin injection for the first time or six months or more after the previous injection. A Pentacam® examination was carried out in all patients before and 4 weeks after the injection. Results Thirty-one eyes were included. Twenty-two had a diagnosis of blepharospasm and nine of hemifacial spasm. Analysis of corneal and anterior chamber parameters revealed a significant decrease in iridocorneal angle after botulinum toxin injection (from 35 ± 10º to 33.8 ± 9.7º, p = 0.022). No other corneal or anterior chamber parameters changed significantly after the injection. Conclusions Periocular botulinum toxin injection causes narrowing of the iridocorneal angle.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of the periocular botulinum toxin on the ocular surface and anterior chamber: a prospective study in patients with hemifacial spasm and blepharospasm

et al. 2023

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“…While acquired SOP presents with vertical diplopia, torsional diplopia, or torticollis, the effect of the prism is limited. Botulinum toxin A (BTA), the most potent type of biological toxin, blocks the release of acetylcholine at the neuromuscular junctions of cholinergic nerves, leading to muscle paralysis, and is approved for therapeutic use in different etiologies of strabismus including both acute and chronic forms (6)(7)(8)(9)(10), and it has been reported to be used in the treatment of SOP (11).…”

Section: Introductionmentioning

confidence: 99%

Improvement in health-related quality of life with Botulinum toxin A injection in acquired superior oblique palsy

Chen

et al. 2023

Front. Med.

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PurposeThis study aimed to investigate the outcomes of Botulinum toxin A (BTA) injection into the inferior oblique (IO) muscle for the management of unilateral acute acquired superior oblique palsy (SOP) and to evaluate changes in health-related quality of life post-injection using the Adult Strabismus-20 (AS-20) questionnaire.MethodsA prospective cohort study was performed in patients with unilateral acute acquired SOP who received BTA injections. Four units of BTA were injected into the ipsilateral IO muscle. Ocular examinations were performed pre-and post-injection, including alignment, ocular movement, and cyclotorsion deviation. The patients’ AS-20 questionnaire scores were analyzed.ResultsA total of 21 patients with acute acquired SOP were included. The initial median vertical deviation was 5 PD (range 1–16), which was improved to 0 PD (range 0–10) at both 1 and 6 months post-injection (p < 0.001 and p < 0.001, respectively). The median torsional deviation was 7° (range 2–18) at baseline and resolved to 0 degrees (range −3–5) at the 1-month and 0° (range −2–7) at the 6-month follow-up (p < 0.001 and p < 0.001, respectively). There were significant increases in the overall score (OAS), psychosocial subscale score (PSS), and functional subscale score (FSS) from baseline values at both the 1-month (p < 0.001, p < 0.001, and p = 0.001, respectively) and 6-month follow-up (all p < 0.001).ConclusionInjecting BTA into the ipsilateral IO muscle successfully resolved vertical and torsional deviations and significantly improved quality-of-life scores. Our findings show that BTA treatment, as an early treatment for acute acquired SOP, can help patients by significantly improving their quality of life.

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“… 1 , 2 Despite a dearth of randomized controlled trials, BTXA seems to have comparable results with surgery in selected motility problems. 3 , 4 , 5 In this paper, the best indications for the use of BTXA, hereafter referred to as “golden indications,” will be highlighted with literature results and the author’s own experience with the use of BTXA in strabismus over 30 years.…”

Section: Introductionmentioning

confidence: 99%

Golden Indications and an Overview on the Use of Botulinum Toxin in Strabismus

Özkan

2023

tjo

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Botulinum toxin A (BTXA) is considered a pharmacological agent that may provide an alternative treatment to surgery in strabismus. It can be used as both a diagnostic and therapeutic agent in various concomitant, paralytic, and restrictive disorders. The major advantage of BTXA treatment is that it is non-invasive and does not impact the patient’s chance for future surgery in case of an unfavorable response. In some selected disorders, BTXA has become the primary choice of treatment, whereas surgery is found to be more effective in others. Accumulated knowledge and experience have demonstrated that BTXA is more than merely an alternative treatment and has additional specific indications such as in unstable deviations and as an adjunct to surgery. Patients with recurrent deviations despite multiple surgeries are also good candidates for BTXA treatment. Although the major expectation is to obtain a permanent result, BTXA can also be used as a maintenance treatment. This paper mainly focuses on the current indications for the use of BTXA in strabismology, with special emphasis on ideal first-choice applications referred to as “golden indications,” within the scope of the author’s own experience with the use of BTXA over 30 years.

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Botulinum Toxin Injection for the Treatment of Strabismus

Cited by 13 publications

References 28 publications

Effects of the periocular botulinum toxin on the ocular surface and anterior chamber: a prospective study in patients with hemifacial spasm and blepharospasm

Effects of the periocular botulinum toxin on the ocular surface and anterior chamber: a prospective study in patients with hemifacial spasm and blepharospasm

Improvement in health-related quality of life with Botulinum toxin A injection in acquired superior oblique palsy

Golden Indications and an Overview on the Use of Botulinum Toxin in Strabismus

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