Cargando…
Botulinum Toxin Injection for Treatment of Acute Traumatic Superior Oblique Muscle Palsy
PURPOSE: To evaluate the outcomes of botulinum toxin injection into the inferior oblique (IO) muscle for management of unilateral acute traumatic superior oblique (SO) palsy. METHODS: In this prospective case series, 10-20 units of botulinum toxin A (Dysport, Ipsen, Biopharm Ltd., Wrexham, UK) was i...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2015
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4687259/ https://www.ncbi.nlm.nih.gov/pubmed/26730311 http://dx.doi.org/10.4103/2008-322X.170350 |
_version_ | 1782406597868257280 |
---|---|
author | Talebnejad, Mohammad Reza Tahamtan, Maryam Nowroozzadeh, M. Hossein |
author_facet | Talebnejad, Mohammad Reza Tahamtan, Maryam Nowroozzadeh, M. Hossein |
author_sort | Talebnejad, Mohammad Reza |
collection | PubMed |
description | PURPOSE: To evaluate the outcomes of botulinum toxin injection into the inferior oblique (IO) muscle for management of unilateral acute traumatic superior oblique (SO) palsy. METHODS: In this prospective case series, 10-20 units of botulinum toxin A (Dysport, Ipsen, Biopharm Ltd., Wrexham, UK) was injected into the ipsilateral IO muscle of 13 consecutive patients with unilateral acute traumatic SO palsy. All patients received injections within four weeks of the incident. RESULTS: Mean age was 29 ± 15 years and 12 (92%) subjects were male. Mean amount of hypertropia (in primary position) was decreased from 10.0 ± 3.9(Δ) at baseline to 4.6 ± 8.9(Δ), one month after the injection, and to 1.5 ± 2.7(Δ) at final follow-up (P = 0.001). IO overaction improved from 2.7 ± 0.6 to 1.0 ± 1.2 and 0.6 ± 0.9 (P ≤ 0.001), and subjective torsion from 5.3 ± 3.9 to 3.2 ± 3.4 and 1.6 ± 2.5 degrees (P ≤ 0.001), at the same time intervals respectively. One month after the injection as well as at final follow-up, 10 (77%) patients were diplopia-free in primary and reading positions. Subgroup analysis showed that patients who recovered had less baseline hypertropia as compared to those who failed (8.3(Δ) vs. 15.7(Δ), respectively; P = 0.01). All patients with a favorable outcome had baseline hypertropia of 10(Δ) or less. CONCLUSION: A single injection of BTA into the IO muscle can rapidly and safely resolve symptomatic diplopia in patients with acute traumatic SO palsy, while waiting for spontaneous recovery. |
format | Online Article Text |
id | pubmed-4687259 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-46872592016-01-04 Botulinum Toxin Injection for Treatment of Acute Traumatic Superior Oblique Muscle Palsy Talebnejad, Mohammad Reza Tahamtan, Maryam Nowroozzadeh, M. Hossein J Ophthalmic Vis Res Original Article PURPOSE: To evaluate the outcomes of botulinum toxin injection into the inferior oblique (IO) muscle for management of unilateral acute traumatic superior oblique (SO) palsy. METHODS: In this prospective case series, 10-20 units of botulinum toxin A (Dysport, Ipsen, Biopharm Ltd., Wrexham, UK) was injected into the ipsilateral IO muscle of 13 consecutive patients with unilateral acute traumatic SO palsy. All patients received injections within four weeks of the incident. RESULTS: Mean age was 29 ± 15 years and 12 (92%) subjects were male. Mean amount of hypertropia (in primary position) was decreased from 10.0 ± 3.9(Δ) at baseline to 4.6 ± 8.9(Δ), one month after the injection, and to 1.5 ± 2.7(Δ) at final follow-up (P = 0.001). IO overaction improved from 2.7 ± 0.6 to 1.0 ± 1.2 and 0.6 ± 0.9 (P ≤ 0.001), and subjective torsion from 5.3 ± 3.9 to 3.2 ± 3.4 and 1.6 ± 2.5 degrees (P ≤ 0.001), at the same time intervals respectively. One month after the injection as well as at final follow-up, 10 (77%) patients were diplopia-free in primary and reading positions. Subgroup analysis showed that patients who recovered had less baseline hypertropia as compared to those who failed (8.3(Δ) vs. 15.7(Δ), respectively; P = 0.01). All patients with a favorable outcome had baseline hypertropia of 10(Δ) or less. CONCLUSION: A single injection of BTA into the IO muscle can rapidly and safely resolve symptomatic diplopia in patients with acute traumatic SO palsy, while waiting for spontaneous recovery. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4687259/ /pubmed/26730311 http://dx.doi.org/10.4103/2008-322X.170350 Text en Copyright: © 2015 Journal of Ophthalmic and Vision Research http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Talebnejad, Mohammad Reza Tahamtan, Maryam Nowroozzadeh, M. Hossein Botulinum Toxin Injection for Treatment of Acute Traumatic Superior Oblique Muscle Palsy |
title | Botulinum Toxin Injection for Treatment of Acute Traumatic Superior Oblique Muscle Palsy |
title_full | Botulinum Toxin Injection for Treatment of Acute Traumatic Superior Oblique Muscle Palsy |
title_fullStr | Botulinum Toxin Injection for Treatment of Acute Traumatic Superior Oblique Muscle Palsy |
title_full_unstemmed | Botulinum Toxin Injection for Treatment of Acute Traumatic Superior Oblique Muscle Palsy |
title_short | Botulinum Toxin Injection for Treatment of Acute Traumatic Superior Oblique Muscle Palsy |
title_sort | botulinum toxin injection for treatment of acute traumatic superior oblique muscle palsy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4687259/ https://www.ncbi.nlm.nih.gov/pubmed/26730311 http://dx.doi.org/10.4103/2008-322X.170350 |
work_keys_str_mv | AT talebnejadmohammadreza botulinumtoxininjectionfortreatmentofacutetraumaticsuperiorobliquemusclepalsy AT tahamtanmaryam botulinumtoxininjectionfortreatmentofacutetraumaticsuperiorobliquemusclepalsy AT nowroozzadehmhossein botulinumtoxininjectionfortreatmentofacutetraumaticsuperiorobliquemusclepalsy |