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. 2021 Jan 12:15:113-120.
doi: 10.2147/OPTH.S294396. eCollection 2021.

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

Fatemah T Alshamlan  1 , Halla A Al Abdulhadi  1 , Mofi M Alwalmany  1 , Khalid S Alotaibi  1
Affiliations

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

Fatemah T Alshamlan et al. Clin Ophthalmol. .

Abstract

Background: 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: angle of deviation; botulinum toxin A; esotropia.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Total participants: males (n=23) females (n=33).
Figure 2
Figure 2
Percentages of the diagnoses from the total number.
See this image and copyright information in PMC

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