Botulinum treatment of infantile esotropia with abduction nystagmus.
OBJECTIVE
To examine the effect of botulinum toxin type A (BTA) on the final correction of esotropia, A and V patterns, overaction of the oblique muscles, and dissociated vertical deviation (DVD) in infantile esotropia with nystagmus in abduction.


METHODS
This retrospective study examined 54 patients treated with simultaneous bilateral medial injection of BTA. Subjects were divided into two groups: group 1 (first injection <18 months of age) and group 2 (first injection >18 months of age).


RESULTS
Pre-BTA, group 1 patients had an angle of esotropia noticeably higher and fewer A patterns than group 2 patients. Post-BTA, group 2 received significantly fewer injections of BTA than group 1. The magnitude of the A patterns improved. Prior frequency of DVD increased significantly in group 1 (100%): 79% of DVD was decompensated compared with 47% in group 2. Overall success was obtained in 14% and 58% of groups 1 and 2, respectively.


CONCLUSIONS
We do not support BTA treatment in infantile esotropia with nystagmus in abduction prior to age 18 months. After 18 months, the horizontal results are excellent and neither the incidence nor the degree of previous DVD are decompensated, resulting in high success rates for overall deviation and improving anisotropy in A.
Ruiz
M F
MF
Servico de Ofalmología, Hospital Ramón y Cajal, Madrid, Spain.
Moreno
M
M
Sánchez-Garrido
C M
CM
Rodríguez
J M
JM
D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D002675:Child, Preschool; D004576:Electromyography; D004948:Esotropia / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular; D008297:Male; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D009759:Nystagmus, Pathologic / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies; D015348:Vision, Binocular / Q000502:physiology
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A