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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Autores principales:	Alshamlan FT, Al Abdulhadi HA, Alwalmany MM, Alotaibi KS
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	esotropia botulinum toxin a angle of deviation Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/d7dfc66ec7fa47db833efce8b28478e9
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spelling	oai:doaj.org-article:d7dfc66ec7fa47db833efce8b28478e92021-12-02T12:48:54ZThe Efficacy of Dose Increments of Botulinum Toxin A in the Treatment of Childhood Esotropia1177-5483https://doaj.org/article/d7dfc66ec7fa47db833efce8b28478e92021-01-01T00:00:00Zhttps://www.dovepress.com/the-efficacy-of-dose-increments-of-botulinum-toxin-a-in-the-treatment--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Fatemah 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 deviationAlshamlan FTAl Abdulhadi HAAlwalmany MMAlotaibi KSDove Medical Pressarticleesotropiabotulinum toxin aangle of deviationOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 113-120 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	esotropia botulinum toxin a angle of deviation Ophthalmology RE1-994
spellingShingle	esotropia botulinum toxin a angle of deviation Ophthalmology RE1-994 Alshamlan FT Al Abdulhadi HA Alwalmany MM Alotaibi KS The Efficacy of Dose Increments of Botulinum Toxin A in the Treatment of Childhood Esotropia
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
format	article
author	Alshamlan FT Al Abdulhadi HA Alwalmany MM Alotaibi KS
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
publishDate	2021
url	https://doaj.org/article/d7dfc66ec7fa47db833efce8b28478e9
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The Efficacy of Dose Increments of Botulinum Toxin A in the Treatment of Childhood Esotropia

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