Botulinum toxin injection of the inferior oblique muscle for the treatment of superior oblique muscle palsy.
OBJECTIVE
To evaluate botulinum toxin injection of the inferior oblique muscle for management of superior oblique (SO) paresis.


METHODS
We undertook a prospective case series of injections of the ipsilateral inferior oblique (IO) muscle with 10-20 units of botulinum toxin type A in patients with a SO muscle palsy/paresis of less than 2 years' duration.


RESULTS
We enrolled 16 patients (18 eyes) with a mean age of 33.7 years. The median time from onset of symptoms until injection was 6 months. The cause of paresis was trauma for 81% of the patients. The mean hypertropia decreased from 6.4(Delta) to 1.9(Delta) at 6 months after treatment. Other clinical measures improved: mean IO overaction from + 1.7 to + 0.6, mean SO underaction from -1.5 to -0.4, mean subjective torsion from 9.3 degrees to 0.4 degrees , and mean head tilt from 8.4 degrees to 1.1 degrees.


CONCLUSIONS
Botulinum toxin injection to IO muscle reduces the symptoms of SO paresis while patients are waiting for recovery.
Bagheri
Abbas
A
Department of Ophthalmology, Labbafinejad Hospital, Shahid Beheshti University, Ophthalmic Research Center, Tehran, Iran. abbasbagheri@yahoo.com
Eshaghi
Mohammad
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002648:Child; D004172:Diplopia / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D009801:Oculomotor Muscles / Q000187:drug effects*; D011446:Prospective Studies; D013285:Strabismus / Q000188:drug therapy*; D016896:Treatment Outcome; D020432:Trochlear Nerve Diseases / Q000188:drug therapy*; D015348:Vision, Binocular
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A