Treatment of acute acquired concomitant esotropia

Shi, Minghua; Zhou, Yuanxiang; Qin, Aijiao; Cheng, Jing; Ren, Hongxing

doi:10.1186/s12886-020-01787-1

Cited by 17 publications

(14 citation statements)

References 19 publications

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“…One of the important reasons for this phenomenon is that patients with AACE tend to avoid looking at the distance due to more obvious diplopia for distant targets, so that it is difficult for AACE patients to effectively reduce the time spent on near-work such as use of smartphone. So we agreed with Shi [ 26 ] that successful treatment was almost unavailable simply by recommending patients to reduce the use of smartphone and other screens. Therefore, in this study, in addition to recommending to reduce the use of smartphone and other screens for patients with AACE, we designed a nonsurgical management approach using a prism to enhance the abduction of patients, regain a balance between convergence and divergence, and achieve the effect of correcting eye position and eliminating diplopia.…”

Section: Discussionmentioning

confidence: 55%

Prismatic treatment of acute acquired concomitant esotropia of 25 prism diopters or less

Feng

et al. 2022

BMC Ophthalmol

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Background This study aimed to assess the efficacy of prismatic treatment in a step-by-step manner to reduce prismatic strength in acute acquired concomitant esotropia (AACE) of 25 prism diopters (PD) or less. Methods In this retrospective comparative study, 36 patients with AACE with deviation angle ≤ 25 PD were treated with Fresnel prism in a step-by-step manner to reduce prismatic strength. The patients were divided into two groups according to whether they regained orthophoria and were weaned off the press-on prisms within 1 year: (1) the treatment-success group, which consisted of patients who had their esotropia eliminated and were weaned off the press-on prisms within 1 year after prism correction, and (2) the treatment-continuing group, which comprised patients who needed to continue wearing a Fresnel prism at 1 year after the beginning of prismatic correction because diplopia and esotropia still existed. Clinical characteristics and cooperation were analyzed and compared between groups. Results Fourteen of 36 patients (38.9%) were weaned off the prism and regained orthophoria and binocular single vision within 1 year after prismatic treatment. Compared with the treatment-continuing group, the treatment-success group showed smaller deviation at near and distant fixations (P = 0.024 and P = 0.006, respectively) measured at the beginning of prismatic correction, a shorter time from onset to prismatic treatment (P = 0.02), and a greater percentage of patients exhibiting good cooperation (P < 0.001). Conclusions Prismatic treatment in a step-by-step manner to reduce prismatic strength can lead to good outcomes of motor alignment and binocular function in patients with AACE of 25 PD or less. Patients showing good cooperation, smaller angle of esotropia, and shorter duration from onset to treatment tend to eliminate esotropia and be weaned off press-on prisms within 1 year after prismatic correction.

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Section: Discussionmentioning

confidence: 55%

Prismatic treatment of acute acquired concomitant esotropia of 25 prism diopters or less

Feng

et al. 2022

BMC Ophthalmol

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“…A study by Wan et al 9 with 33 patients in the surgery group and 16 in the botulinum toxin group yielded similar results at six and 18 months (61% vs 81%, p = 0.20, and 58% vs 67%, p = 0.74, respectively). A prospective non-randomized clinical study by Shi et al, 4 with 20 cases in the surgery group and 40 in the botulinum toxin group, also found no significant difference. This discrepancy from our study may be attributable to the difference in doses and methods of botulinum toxin injection.…”

Section: Discussionmentioning

confidence: 91%

“… 8 Botulinum toxin was first used to treat strabismus in 1979 11 and is now regularly used to treat various types of strabismus, including AACE. 4 , 9–13 …”

Section: Discussionmentioning

confidence: 99%

“…This discrepancy from our study may be attributable to the difference in doses and methods of botulinum toxin injection. Our study used only a single 5 IU dose of botulinum toxin in all cases, whereas Shi study 4 administered repeated injections if the patient had not achieved orthotropia or had a deviation angle within 10 PD. In our study, injection was made in only one medial rectus muscle of the deviating eye, whereas both medial rectus muscles were injected with 5 IU dose in the Wan study 9 and 2.5 IU dose in the Lang study.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have reported botulinum toxin injection as being as effective as conventional rectus muscle surgery. 4 , 9 , 13 However, the samples in those studies were too small to draw a definitive conclusion. Based on our personal clinical experience, we hypothesize that botulinum toxin may not be as effective as strabismus surgery and the magnitude of deviation may alter the result of treatment.…”

Section: Introductionmentioning

confidence: 98%

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Botulinum Toxin Injection versus Extraocular Muscle Surgery for Acute Acquired Comitant Esotropia

Suwannaraj¹,

Rojanasaksothron²,

Methapisittikul³

et al. 2023

OPTH

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Purpose To compare the success rate of extraocular muscle surgery and botulinum toxin injection for treatment in patients with acute acquired comitant esotropia (AACE). Patients and Methods This is a retrospective cohort study in which we treated 34 patients of AACE with botulinum toxin compared with 80 patients who had been treated with surgery. The data included angle of deviation in prism diopter (PD) at baseline and one, three, and six months after treatment. The main outcome was the success rate in each treatment group. Results In the surgery group, mean esodeviation angles at baseline and one, three, and six months after treatment were 50.8 ± 18.3 PD, 4.9 ± 8.3 PD, 4.6 ± 9.5 PD, and 5.5 ± 10.3 PD, whereas those in the botulinum toxin group were 51.2 ± 14.3 PD, 13.9 ± 17.4 PD, 22.0 ± 19.3, and 31.3 ± 23.8 PD, respectively. There was a statistically significant difference in the deviation angles between the two groups ( p < 0.001). The success rate in the surgery group at one, three, and six months was 81%, 84%, and 79%, whereas that in the botulinum toxin group was 50%, 27%, and 27%. Conclusion Botulinum toxin injection was not as effective as conventional extraocular muscle surgery in AACE patients. However, the treatment is safe, fast-acting, and improves both cosmetic appearance and quality of life. This may be considered as a chance for patients not preferring surgery.

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2021 trends in the treatment of patients with strabismus in Japan

Kunimi,

Goseki,

Nishina

et al. 2024

Jpn J Ophthalmol

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Purpose To clarify the actual status of strabismus surgery and botulinum toxin (BTX) therapy in Japan in the year 2021. Study design Cross-sectional study. Methods We conducted a national survey of strabismus treatment in 2021 using a questionnaire consistent with a previous 2013 survey, incorporating additional questions about BTX therapy. Results Among the 378 responding institutions, strabismus surgery or BTX therapy, or both, was performed at 185 institutions (49%; total cases, 10,767). In 151 (40%), 32 (8%), and 2 (1%) institutions, surgery only, surgery and BTX therapy, and BTX therapy only were performed, respectively. The distribution of institutions where strabismus surgery was performed consisted of 4 prefectures, accounting for 48% of the total, whereas no strabismus surgery was performed at any institution in 3 prefectures. Although the highest percentage of patients (23%) was aged between 10 and 19 years, 48.2% of the patients were aged 20 years or older, and 17% of them were aged 60 years or older. Exotropia (XT) was the most common type of strabismus (55%) followed by esotropia (ET) (24%). In terms of complex surgeries, 80.2% (more than 100 cases) were performed at institutions with more than 100 cases. Of the 34 institutions where BTX therapy was performed, 52% were performed at a single institution, and 18% were performed at 2 institutions where no strabismus surgery was performed. Patients with scarring in the extraocular muscles, such as thyroid eye disease, were the most treated, followed by those with ET, who were mainly given injection treatment. Conclusion Institutions where strabismus surgery and BTX therapy could be performed were concentrated and limited.

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Treatment of acute acquired concomitant esotropia

Cited by 17 publications

References 19 publications

Prismatic treatment of acute acquired concomitant esotropia of 25 prism diopters or less

Prismatic treatment of acute acquired concomitant esotropia of 25 prism diopters or less

Botulinum Toxin Injection versus Extraocular Muscle Surgery for Acute Acquired Comitant Esotropia

2021 trends in the treatment of patients with strabismus in Japan

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