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

Rita Gama1, Joana Chambel Santos2, Tânia Yang Nom2

  • 1Hospital da Luz and Gama Eye Care , Lisbon, Portugal.

Journal of Binocular Vision and Ocular Motility
|June 9, 2020
PubMed

Insights

Botulinum toxin A (BTA) injections showed delayed differences in ocular alignment and stereoacuity between infantile esotropia (IET) and nonaccommodative esotropia (NAET) patients after two years. BTA may be a first-line treatment for NAET but an alternative for IET.

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.
Abstract

Keywords:
Botulinum toxininfantile esotropianonaccommodative esotropia

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