title: Presence of fusion in albinism after strabismus surgery augmented with botulinum toxin (type a) injection.
abstract: It is commonly accepted that albino patients with strabismus rarely achieve binocularity and depth perception after strabismus surgery. The presence of retino-geniculo-cortical misrouting, a hallmark of the visual system in albinism, does not necessarily cause total loss of binocular vision, however, not even in albino patients with strabismus. Recently some degrees of stereopsis were reported in albinism patients with minimal clinical nystagmus, if any, in the absence of strabismus. It is possible that patients with albinism and strabismus have binocular visual potential which appears after strabismus correction and provides appropriate postoperative alignment in the long term. Here we present two cases of clinically diagnosed oculocutaneous albinism, an 18-year-old girl and a 16-year-old boy, both with exotropia ≥40 prism diopter, who gained acceptable alignment and fusion after surgical correction of their strabismus as demonstrated on Bagolini testing. In cases of albinism accompanied by visual pathway abnormalities and strabismus, binocular visual potential is not impossible, and some levels can be expected. Thus, these patients, like other cases of strabismus, may benefit from treatment of strabismus at an earlier age to achieve appropriate alignment, cosmetic satisfaction, and a possibly increased chance of fusion.
authors.affiliation: Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran. stavakkolizadeh@noorvision.com
authors.forename: Sepideh
authors.initials: S
authors.lastname: Tavakolizadeh
authors.forename: Azadeh
authors.initials: A
authors.lastname: Farahi
mesh_terms: D000293:Adolescent; D016115:Albinism, Oculocutaneous / Q000188:drug therapy* / Q000601:surgery*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D009465:Neuromuscular Agents / Q000627:therapeutic use; D013285:Strabismus / Q000188:drug therapy* / Q000601:surgery*; D016896:Treatment Outcome; D014795:Visual Pathways / Q000187:drug effects / Q000601:surgery
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
keywords: Albinism; Botulinum toxins; Strabismus
references.citation: Surv Ophthalmol. 1991 Jul-Aug;36(1):28-46
references.pmid: 1925943
references.citation: J AAPOS. 2001 Apr;5(2):98-104
references.pmid: 11304818
references.citation: Invest Ophthalmol Vis Sci. 1997 Dec;38(13):2800-9
references.pmid: 9418733
references.citation: J AAPOS. 2006 Oct;10(5):404-8
references.pmid: 17070473
references.citation: Am J Ophthalmol. 2004 Dec;138(6):978-87
references.pmid: 15629289
references.citation: J AAPOS. 2006 Apr;10(2):124-7
references.pmid: 16678746
references.citation: Br J Ophthalmol. 1995 Feb;79(2):139-43
references.pmid: 7696233
references.citation: Vision Res. 1989;29(10):1359-70
references.pmid: 2635465