The Efficacy of Dose Increments of Botulinum Toxin A in the Treatment of Childhood Esotropia

Fatemah T Alshamlan, Halla A Al Abdulhadi, Mofi M Alwalmany, Khalid S Alotaibi Pediatric Ophthalmology and Strabismus Department, Dhahran Eye Specialist Hospital, Dhahran, Saudi ArabiaCorrespondence: Fatemah T AlshamlanPediatric Ophthalmology and Strabismus Department, Dhahran Eye Specialist Hospita...

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Main Authors: Alshamlan FT, Al Abdulhadi HA, Alwalmany MM, Alotaibi KS
Format: Article
Language:English
Published: Dove Medical Press 2021-01-01
Series:Clinical Ophthalmology
Subjects:
Online Access:https://www.dovepress.com/the-efficacy-of-dose-increments-of-botulinum-toxin-a-in-the-treatment--peer-reviewed-article-OPTH
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spelling doaj-d7dfc66ec7fa47db833efce8b28478e92021-01-12T22:45:02ZengDove Medical PressClinical Ophthalmology1177-54832021-01-01Volume 1511312061092The Efficacy of Dose Increments of Botulinum Toxin A in the Treatment of Childhood EsotropiaAlshamlan FTAl Abdulhadi HAAlwalmany MMAlotaibi KSFatemah T Alshamlan, Halla A Al Abdulhadi, Mofi M Alwalmany, Khalid S Alotaibi Pediatric Ophthalmology and Strabismus Department, Dhahran Eye Specialist Hospital, Dhahran, Saudi ArabiaCorrespondence: Fatemah T AlshamlanPediatric Ophthalmology and Strabismus Department, Dhahran Eye Specialist Hospital, P.O. Box 39301, Dhahran 31942, Saudi ArabiaEmail dr_fate82@hotmail.comBackground: Botulinum toxin is known to have a powerful chemodenervation effect, and it is a well-established alternative to incisional surgery for strabismus. This study aims to investigate the efficacy of dose increments of botulinum toxin A (BTA) for the treatment of specific ranges of angle deviation.Methods: This was a prospective study that included patients presenting with esotropia to Dhahran Eye Specialist Hospital between 2016 and 2020, who were managed by a single surgeon. Botulinum toxin was given in different dosages (2.5, 5, 7.5, 10 international units (IU)) according to the size of deviation (11– 19, 20– 29, 30– 39, and ≥ 40 prism diopters (PD)), respectively. A successful outcome was defined as deviation ≤ 10 PD in the last visit (a minimum of 6 months) following a single injection.Results: A total of 56 patients with esotropia were included. The mean pre-treatment angle of deviation was 38.6 ± 2.5 PD. BTA injection in a dose of 2.5 IU for the 11– 19 PD angle of deviation showed the highest rate of successful outcomes (75%). According to the type of esotropia, partially accommodative esotropia showed the best response to the use of dose increments (59%). The incidence of ptosis post-BTA injection was the least (37.5%) with the smallest dose (2.5 IU).Conclusion: BTA usage in dose increments is safe, efficient, and might be more cost-effective with less incidence of BTA associated complications. Different esotropia diagnoses have different clinical responses. However, larger studies are necessary to better predict the outcome of using dose increments.Keywords: esotropia, botulinum toxin A, angle of deviationhttps://www.dovepress.com/the-efficacy-of-dose-increments-of-botulinum-toxin-a-in-the-treatment--peer-reviewed-article-OPTHesotropiabotulinum toxin aangle of deviation
collection DOAJ
language English
format Article
sources DOAJ
author Alshamlan FT
Al Abdulhadi HA
Alwalmany MM
Alotaibi KS
spellingShingle Alshamlan FT
Al Abdulhadi HA
Alwalmany MM
Alotaibi KS
The Efficacy of Dose Increments of Botulinum Toxin A in the Treatment of Childhood Esotropia
Clinical Ophthalmology
esotropia
botulinum toxin a
angle of deviation
author_facet Alshamlan FT
Al Abdulhadi HA
Alwalmany MM
Alotaibi KS
author_sort Alshamlan FT
title The Efficacy of Dose Increments of Botulinum Toxin A in the Treatment of Childhood Esotropia
title_short The Efficacy of Dose Increments of Botulinum Toxin A in the Treatment of Childhood Esotropia
title_full The Efficacy of Dose Increments of Botulinum Toxin A in the Treatment of Childhood Esotropia
title_fullStr The Efficacy of Dose Increments of Botulinum Toxin A in the Treatment of Childhood Esotropia
title_full_unstemmed The Efficacy of Dose Increments of Botulinum Toxin A in the Treatment of Childhood Esotropia
title_sort efficacy of dose increments of botulinum toxin a in the treatment of childhood esotropia
publisher Dove Medical Press
series Clinical Ophthalmology
issn 1177-5483
publishDate 2021-01-01
description Fatemah T Alshamlan, Halla A Al Abdulhadi, Mofi M Alwalmany, Khalid S Alotaibi Pediatric Ophthalmology and Strabismus Department, Dhahran Eye Specialist Hospital, Dhahran, Saudi ArabiaCorrespondence: Fatemah T AlshamlanPediatric Ophthalmology and Strabismus Department, Dhahran Eye Specialist Hospital, P.O. Box 39301, Dhahran 31942, Saudi ArabiaEmail dr_fate82@hotmail.comBackground: Botulinum toxin is known to have a powerful chemodenervation effect, and it is a well-established alternative to incisional surgery for strabismus. This study aims to investigate the efficacy of dose increments of botulinum toxin A (BTA) for the treatment of specific ranges of angle deviation.Methods: This was a prospective study that included patients presenting with esotropia to Dhahran Eye Specialist Hospital between 2016 and 2020, who were managed by a single surgeon. Botulinum toxin was given in different dosages (2.5, 5, 7.5, 10 international units (IU)) according to the size of deviation (11– 19, 20– 29, 30– 39, and ≥ 40 prism diopters (PD)), respectively. A successful outcome was defined as deviation ≤ 10 PD in the last visit (a minimum of 6 months) following a single injection.Results: A total of 56 patients with esotropia were included. The mean pre-treatment angle of deviation was 38.6 ± 2.5 PD. BTA injection in a dose of 2.5 IU for the 11– 19 PD angle of deviation showed the highest rate of successful outcomes (75%). According to the type of esotropia, partially accommodative esotropia showed the best response to the use of dose increments (59%). The incidence of ptosis post-BTA injection was the least (37.5%) with the smallest dose (2.5 IU).Conclusion: BTA usage in dose increments is safe, efficient, and might be more cost-effective with less incidence of BTA associated complications. Different esotropia diagnoses have different clinical responses. However, larger studies are necessary to better predict the outcome of using dose increments.Keywords: esotropia, botulinum toxin A, angle of deviation
topic esotropia
botulinum toxin a
angle of deviation
url https://www.dovepress.com/the-efficacy-of-dose-increments-of-botulinum-toxin-a-in-the-treatment--peer-reviewed-article-OPTH
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