The Effect of Different Treatment Methods on Acute Acquired Concomitant Esotropia

Huang, Xiaoqi; Meng, Yanfang; Hu, Xuemin; Zhao, Yijia; Ye, Meihong; Yi, Beixi; Zhou, Lianhong

doi:10.1155/2022/5001594

Cited by 7 publications

(16 citation statements)

References 18 publications

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“…6 However, the occurrence rate of complications in the botulinum toxin injection group was found to be considerably lower than that in the surgical group. 6 The aim of surgery is to correct esotropia and eliminate diplopia. 1 However, the optimal plan for the surgery is controversial in patients with AACE.…”

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confidence: 84%

“…6 However, the occurrence rate of complications in the botulinum toxin injection group was found to be considerably lower than that in the surgical group. 6…”

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confidence: 84%

“…1 This preferable timing of surgery for AACE has also been confirmed by others. 6 Good postoperative alignment after the strabismus surgery for AACE has been reported in several studies. 1,6 In conclusion, the author recommends that potential serious neurological diseases and environmental factors should be ruled out as the first step in the management of patients with AACE.…”

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confidence: 88%

“…6 Good postoperative alignment after the strabismus surgery for AACE has been reported in several studies. 1,6 In conclusion, the author recommends that potential serious neurological diseases and environmental factors should be ruled out as the first step in the management of patients with AACE. Then, treatment options should be prioritized so that refractive correction, ocular occlusion, prism prescription, botulinum toxin injection, and strabismus surgery should be orderly considered depending on the patient characteristic variables.…”

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confidence: 88%

“…1 Side effects and treatment costs are lower in botulinum toxin injections than in surgery. 6 A very recent study followed two groups of patients with AACE at 1 week, 1 month, 3 months, and 6 months after two types of treatment, and found that the total efficient rates of the surgical group and the botulinum toxin injection group were 100% and 90.48%, correspondingly. 6 However, the occurrence rate of complications in the botulinum toxin injection group was found to be considerably lower than that in the surgical group.…”

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confidence: 99%

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To prioritize treatment options for acute acquired comitant esotropia

Nouraeinejad

2023

European Journal of Ophthalmology

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The management of acute acquired comitant esotropia (AACE) is controversial, and no clear guidelines exist to guide its treatment options. Therefore, the author proposes his idea that treatment options for AACE should be prioritized to achieve optimal outcomes with fewer potential complications for this type of esotropia. In this manner, treatment should be started with less invasive, muscle-sparing procedures while the patient is regularly checked for improvement in esotropia and diplopia. This is also a good scheme because the patient can go through vital neurological and ophthalmological assessments while he/she is spared from invasive interventions in the beginning.

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mentioning

confidence: 84%

“…6 However, the occurrence rate of complications in the botulinum toxin injection group was found to be considerably lower than that in the surgical group. 6…”

mentioning

confidence: 84%

mentioning

confidence: 88%

mentioning

confidence: 88%

mentioning

confidence: 99%

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To prioritize treatment options for acute acquired comitant esotropia

Nouraeinejad

2023

European Journal of Ophthalmology

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Advances in the diagnosis and treatment of acute acquired comitant esotropia

Guo,

Zhou,

et al. 2024

Int Ophthalmol

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Acute acquired comitant esotropia (AACE) is mainly characterized by sudden onset, accompanied by diplopia, without extraocular muscles paralysis or ocular motility disorders. In recent years, the incidence of AACE has been increasing, researchers have found that this phenomenon may be related to the widespread use of electronic devices and the increase in the number of people working from home during the COVID-19 pandemic. However, its neural mechanisms have not been fully elucidated. This article primarily reviews the latest developments in the diagnosis and treatment of AACE from the perspectives of etiology and treatment methods, aiming to provide direction for future in-depth exploration of the pathogenesis and treatment approaches of this disease.

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Efficacy of augmented-dosed surgery versus botulinum toxin A injection for acute acquired concomitant esotropia: a 2-year follow-up

Yu,

Pan,

Tang

et al. 2023

Br J Ophthalmol

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Background/aimsThis study aims to evaluate the clinical efficacy of botulinum toxin type A (BTXA) injection and augmented-dosed surgery in the treatment of acute acquired concomitant esotropia (AACE), and explore potential risk factors associated with recurrence.MethodsA total of 104 patients diagnosed with AACE between October 2020 and January 2021 were included and voluntarily chose to undergo augmented surgery or BTXA injection. The follow-up assessments ended in November 2022. Multivariable linear regression analysis was used to identify potential factors that influence the dose-response of bilateral medial rectus recession (MRrec). Kaplan-Meier survival analyses and Cox proportional hazards models were performed to evaluate rate and risk factors for AACE relapse.ResultsA total of 31 AACE patients chose augmented-dosed esotropia surgery, and 73 chose BTXA treatment. During the 2-year follow-up, the surgical group achieved more stable postoperative results with no recurrence of diplopia, while only 68.68% (95% CI 55.31% to 78.79%) patients achieved orthophoria in the BTXA group. For patients undergoing BTXA treatment, hours of near work per day were demonstrated to be a significant risk factor for AACE relapse (HR 1.29, 95% CI 1.00 to 1.67). The dose-response of augmented-dosed bilateral MRrec was positively correlated with preoperative deviation angle (R2=0.833; β=0.043, 95% CI 0.031 to 0.055; p<0.001).ConclusionOur findings provided quantitative evidence that augmented-dosed surgery would achieve more stable and favourable surgical outcomes for AACE patients compared with BTXA injection. However, BTXA treatment is still proposed for patients with small deviation angles due to its advantages of reduced trauma, operational simplicity, low cost and quick recovery.

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The Effect of Different Treatment Methods on Acute Acquired Concomitant Esotropia

Cited by 7 publications

References 18 publications

To prioritize treatment options for acute acquired comitant esotropia

To prioritize treatment options for acute acquired comitant esotropia

Advances in the diagnosis and treatment of acute acquired comitant esotropia

Efficacy of augmented-dosed surgery versus botulinum toxin A injection for acute acquired concomitant esotropia: a 2-year follow-up

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