[Botulinum therapy for acute esotropia]

Area of Science:

• Ophthalmology
• Pediatric Medicine
• Neurology

Background:

• Acute esotropia is a common form of strabismus in children.
• Botulinum toxin type A (BoNT-A) is increasingly used for strabismus treatment.
• Evidence on BoNT-A effectiveness in acute pediatric esotropia requires further elucidation.

Purpose of the Study:

• To evaluate the efficacy of botulinum toxin type A in treating acute esotropia in pediatric patients.
• To assess the impact of BoNT-A on eye alignment and binocular vision restoration.

Main Methods:

• Retrospective analysis of 16 children (ages 3-15) with acute esotropia treated with BoNT-A.
• Injections targeted medial rectus muscles, with varying doses based on strabismus angle, age, and disease duration.
• Patients received orthopto-diploptic therapy post-injection; observation period was 12-18 months.

Main Results:

• Persistent orthoposition achieved in 43.75% of patients one month post-chemodenervation.
• Esodeviation angle reduced to ≤2 degrees in 25% of patients.
• Successful binocular vision formation in 81.25% after one year, with 12.5% requiring a second injection and 18.75% needing surgery.

Conclusions:

• Chemodenervation with botulinum toxin type A is a viable treatment for acute esotropia in children.
• BoNT-A facilitates favorable conditions for binocular vision restoration through subsequent therapies.
• This approach offers a promising alternative or adjunct to traditional strabismus surgery.