Session: Free papers Session I - Esotropia 1
The clinical features and management of acute-onset concomitant esotropia in children. The clinical features and management of acute-onset concomitant esotropia in children
Introduction: The aim of this study was to evaluate and compare the clinical features and treatment outcomes of botulinum toxin A (BTX-A) injection and surgery in acute-onset concomitant esotropia (AACE) in children.
Methods: A retrospective, comparative clinical study was conducted. A total of 40 children with AACE who underwent treatment in Beijing Children’s Hospital and were followed-up for at least six months between January 2020 and January 2022 were enrolled. The patients were assigned to two groups according to treatment method: the surgery group (n = 23) and the BTX-A group (n = 17). The successful motor outcome was defined as a final misalignment of less than 5 prism diopters (PD). Successful sensory outcome was defined as any evidence of sensory fusion or stereopsis. Clinical features and treatment outcomes were evaluated using Burian classifications.
Results: In our study, there were five cases of Type I (12.50%), 26 cases of Type II (65.00%), and nine cases of Type III (22.50%) AACE. Successful outcomes were achieved in 38 (95.00%) and 36 (90.00%) of the patients, respectively for near and distance. There was no significant difference between the motor success rate in the two groups, both at distance (P = 0.749) and near (P = 0.826). After treatment, the overall proportions of AACE patients who exhibited fusion and stereopsis were 94.59% (35/37), 86.84% (33/38), and 72.97% (27/37), respectively. Fusion was observed in 100.00% (15/15) of the patients in the BTX-A group and in 90.91% (20/22) of those in the surgery group. The two groups also exhibited similar stereopsis at near and at distance (P = 0.427; P = 0.339).
Conclusions: In this study, Franceschetti Type II is the most common clinical classification of AACE in children. There was no difference in the efficacy of the treatment methods across the three different clinical types. Thus, BTX-A injection could be considered an equivalent, minimally incisional treatment method to surgery.
Methods: A retrospective, comparative clinical study was conducted. A total of 40 children with AACE who underwent treatment in Beijing Children’s Hospital and were followed-up for at least six months between January 2020 and January 2022 were enrolled. The patients were assigned to two groups according to treatment method: the surgery group (n = 23) and the BTX-A group (n = 17). The successful motor outcome was defined as a final misalignment of less than 5 prism diopters (PD). Successful sensory outcome was defined as any evidence of sensory fusion or stereopsis. Clinical features and treatment outcomes were evaluated using Burian classifications.
Results: In our study, there were five cases of Type I (12.50%), 26 cases of Type II (65.00%), and nine cases of Type III (22.50%) AACE. Successful outcomes were achieved in 38 (95.00%) and 36 (90.00%) of the patients, respectively for near and distance. There was no significant difference between the motor success rate in the two groups, both at distance (P = 0.749) and near (P = 0.826). After treatment, the overall proportions of AACE patients who exhibited fusion and stereopsis were 94.59% (35/37), 86.84% (33/38), and 72.97% (27/37), respectively. Fusion was observed in 100.00% (15/15) of the patients in the BTX-A group and in 90.91% (20/22) of those in the surgery group. The two groups also exhibited similar stereopsis at near and at distance (P = 0.427; P = 0.339).
Conclusions: In this study, Franceschetti Type II is the most common clinical classification of AACE in children. There was no difference in the efficacy of the treatment methods across the three different clinical types. Thus, BTX-A injection could be considered an equivalent, minimally incisional treatment method to surgery.