[Permanent consecutive exotropia in children treated with botulinum toxin]

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Neurology

Background:

• Congenital esotropia is the most common form of strabismus in children.
• Botulinum toxin injections are a recognized treatment for congenital esotropia, but outcomes can vary.
• Understanding factors leading to persistent esotropia post-treatment is crucial for optimizing patient care.

Purpose of the Study:

• To determine the frequency of consecutive permanent esotropia after botulinum toxin treatment in congenital esotropia patients.
• To identify associated factors, particularly neurological, contributing to persistent esotropia.
• To analyze treatment parameters and patient characteristics in relation to outcomes.

Main Methods:

• Retrospective review of 84 patients with congenital esotropia treated with botulinum toxin.
• Analysis of pre- and postnatal history, cycloplegic refraction, initial deviation magnitude, and botulinum toxin dosage.
• Assessment of patients with persistent esotropia after a minimum 6-month follow-up.

Main Results:

• 14.28% (12 patients) developed consecutive permanent esotropia.
• The average age of affected patients was 10.75 months, with initial esotropia averaging 37.9 PD.
• Neurological factors, including psychomotor delay in 91.66% of cases, were the most prevalent characteristic.

Conclusions:

• Neurological characteristics are significantly associated with consecutive permanent esotropia following botulinum toxin treatment.
• The study highlights the importance of considering neurological status in managing congenital esotropia.
• Further research into the interplay between neurological conditions and strabismus treatment outcomes is warranted.