Differences of a Single Injection of Botulinum Toxin A between Infantile and Nonaccommodative Esotropia

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Strabismus Treatment

Background:

• Infantile esotropia (IET) and nonaccommodative esotropia (NAET) are common forms of strabismus in children.
• Botulinum toxin A (BTA) injections are used to treat various types of strabismus.

Purpose of the Study:

• To compare the efficacy of a single Botulinum toxin A (BTA) injection in children with infantile esotropia (IET) versus nonaccommodative esotropia (NAET).
• To evaluate ocular alignment and stereoacuity outcomes over a two-year period post-treatment.

Main Methods:

• A retrospective study involving 23 children with IET and 25 with NAET.
• Evaluation of ocular deviation and stereoacuity at 6 months, 1 year, and 2 years post-BTA injection.

Main Results:

• No significant differences in ocular alignment were observed between IET and NAET groups at 6 months and 1 year.
• By 2 years, statistically significant differences emerged in motor alignment (p=0.007) and stereoacuity (p=0.004) favoring the NAET group.
• Temporary side effects like overcorrection and ptosis were common in the first week but resolved by 6 months in both groups.

Conclusions:

• Botulinum toxin A (BTA) can be considered an alternative, not a definitive, treatment for IET, with retreatment or surgery potentially needed after one year.
• BTA may serve as a safe, easy, and effective first-line treatment for NAET, offering long-lasting effects.