Botulinum toxin injection without electromyographic guidance in consecutive esotropia
To investigate the efficacy of botulinum toxin injection without electromyographic guidance for the treatment of consecutive esotropia. A retrospective study was performed on 49 subjects with consecutive esotropia who received botulinum toxin injection in the medial rectus muscles without the use of...
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| description | To investigate the efficacy of botulinum toxin injection without electromyographic guidance for the treatment of consecutive esotropia.
A retrospective study was performed on 49 subjects with consecutive esotropia who received botulinum toxin injection in the medial rectus muscles without the use of electromyographic guidance. Treatment was considered successful if the final ocular alignment was orthotropic or esodeviation was ≤10 prism diopters (PD) during distant fixation.
The mean age was 15.2 ± 8.3 years. The mean esodeviation before injection was 21.8 ± 9.1 PD at distance and 21.3 ± 8.3 PD at near. The mean number of injections per patient was 1.3 ± 0.7, and 46 patients (93.9%) received two or fewer injections. At 6 months after the final injection, the mean angle of esodeviation was 7.3 ± 6.0 PD at distance and 7.5 ± 6.6 PD at near (all p |
| doi_str_mv | 10.1371/journal.pone.0241588 |
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A retrospective study was performed on 49 subjects with consecutive esotropia who received botulinum toxin injection in the medial rectus muscles without the use of electromyographic guidance. Treatment was considered successful if the final ocular alignment was orthotropic or esodeviation was ≤10 prism diopters (PD) during distant fixation.
The mean age was 15.2 ± 8.3 years. The mean esodeviation before injection was 21.8 ± 9.1 PD at distance and 21.3 ± 8.3 PD at near. The mean number of injections per patient was 1.3 ± 0.7, and 46 patients (93.9%) received two or fewer injections. At 6 months after the final injection, the mean angle of esodeviation was 7.3 ± 6.0 PD at distance and 7.5 ± 6.6 PD at near (all p<0.001), and 69.4% showed successful alignment. By multivariate analysis, an initial postoperative esodeviation of ≤18 PD at one month after exotropia surgery was considered to be a predictive factor for successful botulinum toxin injection (P = 0.007). Vertical deviation and/or ptosis occurred in 4 patients (8.2%) at two weeks after injection, which all resolved within three months. There was no recurrence of exotropia up to the final follow-up examination.
Botulinum toxin injection without electromyographic guidance is safe and effective in the treatment of consecutive esotropia without causing recurrent exotropia. Successful botulinum toxin injection is likely in patients with an initial postoperative esodeviation of 18PD or less at one month after exotropia surgery.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0241588</identifier><identifier>PMID: 33180838</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Age ; Aged ; Authorship ; Biology and Life Sciences ; Botulinum toxin ; Botulinum toxins ; Botulinum Toxins, Type A - administration & dosage ; Botulinum Toxins, Type A - adverse effects ; Care and treatment ; Child ; Drug dosages ; Electromyography ; Engineering and Technology ; Esotropia ; Esotropia - drug therapy ; Exotropia - surgery ; Female ; Follow-Up Studies ; Health aspects ; Hospitals ; Humans ; Injection ; Injections, Intramuscular - adverse effects ; Injections, Intramuscular - methods ; Medical records ; Medicine and Health Sciences ; Middle Aged ; Multivariate analysis ; Muscles ; Neuromuscular Agents - administration & dosage ; Neuromuscular Agents - adverse effects ; Oculomotor Muscles - drug effects ; Oculomotor Muscles - innervation ; Ophthalmologic Surgical Procedures - adverse effects ; Patients ; Postoperative Complications - drug therapy ; Postoperative Complications - etiology ; Retrospective Studies ; Strabismus ; Surgery ; Surgical outcomes ; Toxins ; Treatment Outcome ; Young Adult</subject><ispartof>PloS one, 2020-11, Vol.15 (11), p.e0241588</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Yang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Yang et al 2020 Yang et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-727cd3e4801daf52c3d70241fb8a3b998b954143934d70394f08d9ed3e2b36013</citedby><cites>FETCH-LOGICAL-c692t-727cd3e4801daf52c3d70241fb8a3b998b954143934d70394f08d9ed3e2b36013</cites><orcidid>0000-0003-3179-3122 ; 0000-0003-0837-2864</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660504/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660504/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2100,2926,23865,27923,27924,53790,53792,79371,79372</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33180838$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Wang, I-Jong</contributor><creatorcontrib>Yang, Hee Kyung</creatorcontrib><creatorcontrib>Kim, Dong Hyun</creatorcontrib><creatorcontrib>Hwang, Jeong-Min</creatorcontrib><title>Botulinum toxin injection without electromyographic guidance in consecutive esotropia</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To investigate the efficacy of botulinum toxin injection without electromyographic guidance for the treatment of consecutive esotropia.
A retrospective study was performed on 49 subjects with consecutive esotropia who received botulinum toxin injection in the medial rectus muscles without the use of electromyographic guidance. Treatment was considered successful if the final ocular alignment was orthotropic or esodeviation was ≤10 prism diopters (PD) during distant fixation.
The mean age was 15.2 ± 8.3 years. The mean esodeviation before injection was 21.8 ± 9.1 PD at distance and 21.3 ± 8.3 PD at near. The mean number of injections per patient was 1.3 ± 0.7, and 46 patients (93.9%) received two or fewer injections. At 6 months after the final injection, the mean angle of esodeviation was 7.3 ± 6.0 PD at distance and 7.5 ± 6.6 PD at near (all p<0.001), and 69.4% showed successful alignment. By multivariate analysis, an initial postoperative esodeviation of ≤18 PD at one month after exotropia surgery was considered to be a predictive factor for successful botulinum toxin injection (P = 0.007). Vertical deviation and/or ptosis occurred in 4 patients (8.2%) at two weeks after injection, which all resolved within three months. There was no recurrence of exotropia up to the final follow-up examination.
Botulinum toxin injection without electromyographic guidance is safe and effective in the treatment of consecutive esotropia without causing recurrent exotropia. Successful botulinum toxin injection is likely in patients with an initial postoperative esodeviation of 18PD or less at one month after exotropia surgery.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Authorship</subject><subject>Biology and Life Sciences</subject><subject>Botulinum toxin</subject><subject>Botulinum toxins</subject><subject>Botulinum Toxins, Type A - administration & dosage</subject><subject>Botulinum Toxins, Type A - adverse effects</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Drug dosages</subject><subject>Electromyography</subject><subject>Engineering and Technology</subject><subject>Esotropia</subject><subject>Esotropia - drug therapy</subject><subject>Exotropia - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health aspects</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Injection</subject><subject>Injections, Intramuscular - adverse effects</subject><subject>Injections, Intramuscular - methods</subject><subject>Medical records</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Muscles</subject><subject>Neuromuscular Agents - administration & dosage</subject><subject>Neuromuscular Agents - adverse effects</subject><subject>Oculomotor Muscles - drug effects</subject><subject>Oculomotor Muscles - innervation</subject><subject>Ophthalmologic Surgical Procedures - adverse effects</subject><subject>Patients</subject><subject>Postoperative Complications - drug therapy</subject><subject>Postoperative Complications - etiology</subject><subject>Retrospective Studies</subject><subject>Strabismus</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Toxins</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNkt9r1TAcxYs43Jz-B6IFQfDhXvOrafIizKHuwmCgzteQpmmbS5vcJenc_ntTbzduQUH60PLN55wkpyfLXkGwhriEH7Zu9Fb2652zeg0QgQVjT7ITyDFaUQTw04Pv4-x5CFsACswofZYdYwwZYJidZNefXBx7Y8chj-7O2NzYrVbROJv_MrFzY8x1nwbeDfeu9XLXGZW3o6mlVTrBuXI2aDVGc6tzHVwCd0a-yI4a2Qf9cn6fZtdfPv84v1hdXn3dnJ9drhTlKK5KVKoaa8IArGVTIIXrcrpJUzGJK85ZxQsCCeaYpAXMSQNYzXWSoApTAPFp9mbvu-tdEHMiQSBCAWCcQ5yIzZ6ondyKnTeD9PfCSSP-DJxvhfTRqF6LmpdlxZWkChNCwLS_LirNFFcAIYaS18d5t7EadK20jV72C9PlijWdaN2tKCkFBSDJ4O1s4N3NqEP8x5FnqpXpVMY2KVSpBhOUOKMEYoIom7zWf6HSU-vBpJ-iG5PmC8H7hSAxUd_FVo4hiM33b__PXv1csu8O2E7LPnbB9ePUobAEyR5U3oXgdfOYHARiqvRDGmKqtJgrnWSvD1N_FD10GP8Gpivx2g</recordid><startdate>20201112</startdate><enddate>20201112</enddate><creator>Yang, Hee Kyung</creator><creator>Kim, Dong Hyun</creator><creator>Hwang, Jeong-Min</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-3179-3122</orcidid><orcidid>https://orcid.org/0000-0003-0837-2864</orcidid></search><sort><creationdate>20201112</creationdate><title>Botulinum toxin injection without electromyographic guidance in consecutive esotropia</title><author>Yang, Hee Kyung ; Kim, Dong Hyun ; Hwang, Jeong-Min</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-727cd3e4801daf52c3d70241fb8a3b998b954143934d70394f08d9ed3e2b36013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Authorship</topic><topic>Biology and Life Sciences</topic><topic>Botulinum toxin</topic><topic>Botulinum toxins</topic><topic>Botulinum Toxins, Type A - administration & dosage</topic><topic>Botulinum Toxins, Type A - adverse effects</topic><topic>Care and treatment</topic><topic>Child</topic><topic>Drug dosages</topic><topic>Electromyography</topic><topic>Engineering and Technology</topic><topic>Esotropia</topic><topic>Esotropia - drug therapy</topic><topic>Exotropia - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health aspects</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Injection</topic><topic>Injections, Intramuscular - adverse effects</topic><topic>Injections, Intramuscular - methods</topic><topic>Medical records</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Muscles</topic><topic>Neuromuscular Agents - administration & dosage</topic><topic>Neuromuscular Agents - adverse effects</topic><topic>Oculomotor Muscles - drug effects</topic><topic>Oculomotor Muscles - innervation</topic><topic>Ophthalmologic Surgical Procedures - adverse effects</topic><topic>Patients</topic><topic>Postoperative Complications - drug therapy</topic><topic>Postoperative Complications - etiology</topic><topic>Retrospective Studies</topic><topic>Strabismus</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Toxins</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Hee Kyung</creatorcontrib><creatorcontrib>Kim, Dong Hyun</creatorcontrib><creatorcontrib>Hwang, Jeong-Min</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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A retrospective study was performed on 49 subjects with consecutive esotropia who received botulinum toxin injection in the medial rectus muscles without the use of electromyographic guidance. Treatment was considered successful if the final ocular alignment was orthotropic or esodeviation was ≤10 prism diopters (PD) during distant fixation.
The mean age was 15.2 ± 8.3 years. The mean esodeviation before injection was 21.8 ± 9.1 PD at distance and 21.3 ± 8.3 PD at near. The mean number of injections per patient was 1.3 ± 0.7, and 46 patients (93.9%) received two or fewer injections. At 6 months after the final injection, the mean angle of esodeviation was 7.3 ± 6.0 PD at distance and 7.5 ± 6.6 PD at near (all p<0.001), and 69.4% showed successful alignment. By multivariate analysis, an initial postoperative esodeviation of ≤18 PD at one month after exotropia surgery was considered to be a predictive factor for successful botulinum toxin injection (P = 0.007). Vertical deviation and/or ptosis occurred in 4 patients (8.2%) at two weeks after injection, which all resolved within three months. There was no recurrence of exotropia up to the final follow-up examination.
Botulinum toxin injection without electromyographic guidance is safe and effective in the treatment of consecutive esotropia without causing recurrent exotropia. Successful botulinum toxin injection is likely in patients with an initial postoperative esodeviation of 18PD or less at one month after exotropia surgery.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33180838</pmid><doi>10.1371/journal.pone.0241588</doi><tpages>e0241588</tpages><orcidid>https://orcid.org/0000-0003-3179-3122</orcidid><orcidid>https://orcid.org/0000-0003-0837-2864</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Age Aged Authorship Biology and Life Sciences Botulinum toxin Botulinum toxins Botulinum Toxins, Type A - administration & dosage Botulinum Toxins, Type A - adverse effects Care and treatment Child Drug dosages Electromyography Engineering and Technology Esotropia Esotropia - drug therapy Exotropia - surgery Female Follow-Up Studies Health aspects Hospitals Humans Injection Injections, Intramuscular - adverse effects Injections, Intramuscular - methods Medical records Medicine and Health Sciences Middle Aged Multivariate analysis Muscles Neuromuscular Agents - administration & dosage Neuromuscular Agents - adverse effects Oculomotor Muscles - drug effects Oculomotor Muscles - innervation Ophthalmologic Surgical Procedures - adverse effects Patients Postoperative Complications - drug therapy Postoperative Complications - etiology Retrospective Studies Strabismus Surgery Surgical outcomes Toxins Treatment Outcome Young Adult |
| title | Botulinum toxin injection without electromyographic guidance in consecutive esotropia |
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