Effects of botulinum a toxin injection on the extraocular muscle fiber layers: Comparison between subtenon injection and intramuscular injection

Paik, Hae Jung; Kang, Kui Dong; Choi, Jin Seok; Choi, Byung Gil; Yim, Hye Bin

doi:10.1007/s10384-009-0658-7

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…23 Although botulinum toxin type A is often used as an alternative to eye muscle surgery for the treatment of strabismus, some morphological studies on extraocular muscles suggest that botulinum toxins induce ultrastructural changes in the myotendinous nerve endings and that these changes might diminish the proprioceptive abilities of the extraocular muscle. 67,68 Corsi et al 69 and Li and Shen 70 noted alterations in the receptor morphology while analyzing resected rectus muscle specimens from patients who had undergone surgery for concomitant strabismus. They suggested that deranged proprioceptive function contributed to the cause of the strabismus.…”

Section: Palisade Endingsmentioning

confidence: 99%

Neuroanatomical Structures in Human Extraocular Muscles and Their Potential Implication in the Development of Oculomotor Disorders

Paduca¹,

Bruenech²

2018

J Pediatr Ophthalmol Strabismus

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The potential role of sensory feedback from human extraocular muscles has been subjected to considerable speculation in the ophthalmic literature. Extraocular muscles pull against a fairly even load and do not initiate a stretch reflex, even when the eyes are directed toward the boundaries of their respective field of action. These unique working conditions and physiological properties have led to the notion that the sensory signal arising from receptors in extraocular muscles differs from the conventional proprioceptive signal arising from their somatic counterparts. The interest in the receptors at the myotendinous junction of human extraocular muscles has been renewed due to their alleged role in the development of binocular vision and their potential implication in the etiology of binocular vision anomalies. The idea that extraocular muscles provide knowledge of eye position and whether this function can be affected by surgical intervention has initiated several clinical and neuroanatomical studies. Many of these studies support this concept and suggest that surgical procedures that impose only minimal interference with the proprioceptive signal will give a better postoperative result. However, other studies contradict this view because the afferent capacity of the receptors can be questioned and some uncertainties remain. The purpose of this study was to review the related literature and discuss the possible role of ocular proprioceptors in relation to binocular vision and the development of eye motility disorders. [J Pediatr Ophthalmol Strabismus. 2018;55(1):14-22.].

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Section: Palisade Endingsmentioning

confidence: 99%

Neuroanatomical Structures in Human Extraocular Muscles and Their Potential Implication in the Development of Oculomotor Disorders

Paduca¹,

Bruenech²

2018

J Pediatr Ophthalmol Strabismus

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“…This is also extremely rare after botulinum toxin injection with electromyographic guidance [26,27], with an incidence of 0.002% [15]. In rabbits, Paik et al [28] found no different morphologic changes in the extraocular muscle fiber layers between direct intramuscular injection and subtenon injection of botulinum toxin. Therefore, complications after botulinum toxin injection are comparable with and without electromyographic guidance.…”

Section: Plos Onementioning

confidence: 99%

Botulinum toxin injection without electromyographic guidance in consecutive esotropia

2020

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Purpose To investigate the efficacy of botulinum toxin injection without electromyographic guidance for the treatment of consecutive esotropia. Methods 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. Results 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. Conclusion 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.

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Section: Plos Onementioning

confidence: 99%

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Effects of botulinum a toxin injection on the extraocular muscle fiber layers: Comparison between subtenon injection and intramuscular injection

Abstract: Subtenon injection of botulinum A toxin induced similar morphological changes as direct intramuscular injection in the extraocular muscle fiber layers. These results suggest the possibility of clinical applications of subtenon botulinum A toxin injection for the treatment of strabismus.

Cited by 6 publications

References 15 publications

Neuroanatomical Structures in Human Extraocular Muscles and Their Potential Implication in the Development of Oculomotor Disorders

Neuroanatomical Structures in Human Extraocular Muscles and Their Potential Implication in the Development of Oculomotor Disorders

Botulinum toxin injection without electromyographic guidance in consecutive esotropia

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