Clinical characteristics and surgical outcomes of adults with acute acquired comitant esotropia

Lee, Haeng Jin; Kim, Seong Joon

doi:10.1007/s10384-019-00688-1

Cited by 27 publications

(19 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is di cult for these patients to wear prisms for several days. Some authors, including us, prefer to reduce the incidence of undercorrection and avoid the time and expense associated with PAT by increasing the amount of the correction during surgery [2,3,10] We increased the amount of surgery by 1-2 mm beyond what is typical for esotropia surgery.The results showed that the treatment effect was similar to that achieved with botulinum toxin injection. Three of the 20 patients (15%) underwent suture adjustment due to the undercorrection of esotropia, and 4 patients(20%) relapsed after half a year.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of Acute Acquired Concomitant Esotropia

Shi

Zhou

Qin

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The treatment efficacy of botulinum toxin bilateral medial rectus injections for acute acquired concomitant esotropia (AACE) in adult is not clear. We characterize the effects of botulinum toxin injection in the treatment of AACE, especially in patients over 14 years old,and compared it with surgical treatment.Methods: In this prospective, nonrandomized, controlled clinical study, patients with AACE in our hospital from March 2017 to March 2020 elected to receive bilateral medial rectus injections of botulinum toxin or to undergo extraocular muscle surgery. Ocular position and stereopsis were evaluated before and after treatment.Results: A total of 60 patients were treated: 40 patients in the botulinum toxin group, and 20 patients in the surgery group. The botulinum toxin group included 31 cases ≥14 years of age and 9 cases <14 years of age. After 1–3 botulinum injections, the cumulative initial success rate was 95% (38/40), and the recurrence rate was 22.5% (9/40). Nine children <14 years of age were treated successfully, without recurrence. In the surgery group, the initial success rate after surgery was 75% (17/20), and the recurrence rate was 20% (4/20). There was no significant difference between groups in the rate of success rate or the rate of recurrence (P>0.05).Conclusion: The injection of botulinum toxin has a good effect on AACE in adults with minimal squinting and in children. The outcomes achieved with injected botulinum toxin are similar to those achieved with surgery.Trial registration: ChiCTR, ChiCTR2000032544. Registered May 2, 2020，Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=52349

show abstract

Section: Discussionmentioning

confidence: 99%

“…The incidence rate of acute acquired concomitant esotropia has increased dramatically, especially in Asian countries [1][2][3][4][5]. There are various treatments for AACE, includes extraocular muscle surgery, botulinum toxin injection, prisms, and divergence training.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Acute Acquired Concomitant Esotropia

Shi

Zhou

Qin

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…All patients underwent routine ophthalmologic examinations (refraction, visual acuity, outer eye, anterior segment, fundus), head computed tomography (CT) or magnetic resonance imaging (MRI). As descripted previously, AACE was classified into Swan type, Burian-Franceschetti type and Bielschowsky type [ 2 , 3 ]. The accommodative convergence/accommodation (AC/A) ratio was measured with the gradient method preoperatively to check for accommodative esotropia.…”

Section: Methodsmentioning

confidence: 99%

“…Acute acquired comitant esotropia (AACE) is a rare type of esotropia that usually occurs in older children and adults [ 1 ]. It is classified into three types: 1) Swan type: esotropia due to monocular occlusion or loss of vision in one eye; 2) Burian-Franceschetti type: esotropia characterized by minimal hypermetropia and diplopia, often associated with physical or psychological stress; 3) Bielschowsky type: esotropia in patients with varying degrees of myopia, and shows equal deviation at near and distance fixation [ 2 , 3 ]. Its clinical characteristics include an acute onset of comitant esotropia with diplopia (same deviation in all gaze direction), normal ocular motility, recessive, constant or intermittent esotropia, and a certain binocular visual function [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the therapeutic effects of surgery following prism adaptation test versus surgery alone in acute acquired comitant esotropia

2020

View full text Add to dashboard Cite

Background To compare the therapeutic effects of surgery following prism adaptation test versus surgery alone in acute acquired comitant esotropia (AACE). Methods A total of 46 patients with AACE were enrolled in this retrospective study. Among them, 26 patients underwent surgery following prism adaptation test (combination group) and 20 patients underwent surgery alone (surgery group). The following parameters were evaluated including success rate, distant and near deviation angles, visual function, and near stereoacuity. Results There were no significant differences in success rate between the combination group and surgery group at post-treatment 12 months (96.15% vs. 90.00%, p > 0.05). The postoperative distant and near deviation angles in two groups were significantly lower than that before surgery ( p < 0.05). In addition, the numbers of patients with stereopsis postoperatively in two groups were significantly higher than that before surgery (all p < 0.05). Moreover, the numbers of patients with stereopsis and central stereopsis in the combination group were significantly higher than that in the surgery group postoperatively. At post-treatment 12 months, one (3.85%) case recurred in combination group and three (15.00%) cases in the surgery group. No complications were observed in the two groups. Conclusions Both approaches had therapeutic benefit in AACE. Surgery following prism adaptation test had better treatment benefits than surgery alone in improving binocular function and reducing recurrence rate.

show abstract

“…A cute acquired comitant esotropia (AACE) is the peculiar type of rhinoptia and it always appears on adults and some older children [1][2] . AACE is often manifested as the sudden onset of esotropia and diplopia, which also seriously affects the patients' quality of life [3] . Patients with AACE usually have normal extraocular motility, no ophthalmoplegia, and no neurological abnormalities [4][5] .…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of botulinum toxin type A on acute acquired comitant esotropia

Huang¹,

Zhao²,

Ye³

et al. 2022

Int J Ophthalmol

View full text Add to dashboard Cite

AIM: To investigate the effects of micro-injection of botulinum toxin A (BTXA) on acute acquired comitant esotropia (AACE). METHODS: A total of 33 AACE patients who underwent BTXA micro-injection at Renmin Hospital of Wuhan University from September 1st, 2019 to July 1st, 2021 were retrospective analyzed. Esotropia, eye alignment, stereopsis, and complications were examined at baseline (except complications), 1wk, 1, 3, and 6mo after injection. RESULTS: The average angle of deviation before injection was (+20.24±6.80)Δ at near and (+24.76±6.43)Δ at distance, while (+5.15±5.85)Δ at near and (+7.30±6.17)Δ at distance 6mo after treatment (P<0.05). Six months after injection, the stereopsis of patients had improved. The number of patients having no stereopsis (>800 seconds of arc) decreased from 11 to 3. The number of patients having peripheral stereopsis (300-800 seconds of arc), macular stereopsis (70-200 seconds of arc) and central concave stereopsis (≤60 seconds of arc) increased from 10 to 11, 10 to 12, and 2 to 7, respectively. At the follow-ups at 1wk, 1, 3, and 6mo after injection, success rates were 96.97%, 96.97%, 93.94% and 87.88%, respectively. One week after injection, two patients (6.07%) showed subconjunctival hemorrhage; three patients (9.09%) showed limited eye movement and one patient (3.03%) showed mild vertical strabismus. All the symptoms disappeared by the final follow-up. CONCLUSION: Micro-injection of BTXA can reduce diplopia and improve binocular vision function of AACE patients. Furthermore, the operation is relatively safe with few complications, making it an ideal treatment modality for AACE.

show abstract

Clinical characteristics and surgical outcomes of adults with acute acquired comitant esotropia

Cited by 27 publications

References 23 publications

Treatment of Acute Acquired Concomitant Esotropia

Treatment of Acute Acquired Concomitant Esotropia

Comparison of the therapeutic effects of surgery following prism adaptation test versus surgery alone in acute acquired comitant esotropia

Clinical efficacy of botulinum toxin type A on acute acquired comitant esotropia

Contact Info

Product

Resources

About