title: Clinical outcomes of botulinum toxin injection in patients with cerebral palsy and esotropia.
abstract: OBJECTIVE
  To assess the efficacy of botulinum toxin (Novotox) injection in patients with cerebral palsy (CP) and esotropia.
  
  
  METHODS
  In a non-comparative, prospective interventional case series botulinum toxin injection was done in 44 patients with CP and esotropia. A single dose of botulinum toxin was injected in both medial rectus muscles of all patients and was repeated in 12 patients. Angle of deviation within 10 prism diopters (PD) of orthotropia was defined as a successful outcome.
  
  
  RESULTS
  Forty-four patients (21 males) with the mean age of 47.56 ± 35.86 months were included in the study. The mean esotropia in all patients was 52.27 ± 18.40 PD (25-123 PD). The range of follow-up was 12-24 months. Thirty patients (68.18%) were treated successfully one year after surgery. The rates of success, consecutive exotropia, and residual esotropia were 61.4%, 13.63%, and 25% in the last follow-up, respectively. The logistic regression showed statistically significant results between success result and lower age, higher pre-injection deviation, one month post-injection deviation, and severe ptosis. Complications included subconjunctival hemorrhage and ptosis.
  
  
  CONCLUSIONS
  Botulinum toxin injection is reasonably less invasive with light anesthesia, scar free, and a therapeutic alternative for the patient with esotropia and CP. Therefore, it can provide more possible surgical options in future.
authors: Associate Professor of Ophthalmology .
authors: Ahmad
authors: A
authors: Ameri
authors: Arash
authors: A
authors: Mirmohammadsadeghi
authors: Ali
authors: A
authors: Makateb
authors: Fatemeh
authors: F
authors: Bazvand
authors: Simindokht
authors: S
authors: Hosseini
mesh_terms: D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004948:Esotropia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular; D008297:Male; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D009801:Oculomotor Muscles / Q000187:drug effects*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
keywords: Botulinum toxin; cerebral palsy; esotropia