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[肉毒杆菌毒素治疗婴儿内斜视的疗效]

[Efficacy of botulinum toxin in infantile esotropia].

作者信息

Marciano E, Barjol A, Toanen V, Audren F, Caputo G, Clement Corral A

机构信息

CHU Robert Debré, 48, boulevard Serurier, 75019 Paris, France.

Fondation ophtalmologique Adolphe-de-Rothschild, 29, rue Manin, 75019 Paris, France.

出版信息

J Fr Ophtalmol. 2022 Oct;45(8):937-945. doi: 10.1016/j.jfo.2022.04.020. Epub 2022 Aug 23.

Abstract

INTRODUCTION AND OBJECTIVE

Botulinum toxin (BT) is used in a variety of therapeutic applications, including the treatment of strabismus. Two injection techniques coexist - transconjunctival injection and open sky injection. The goal of this study was to evaluate the results of BT injections in esotropia in children under 10 years of age and to compare the two techniques.

PATIENTS AND METHOD

This is a retrospective, monocentric study, including children who received BT injections to treat their strabismus by the aforementioned techniques between 2014 and 2017. The results of these injections were recorded, and subgroup analyses (injection technique, age, degree of deviation, type of strabismus) were performed. The primary endpoint was the optimal success rate defined as residual strabismus less than or equal to 10 Δ.

RESULTS

The study included 68 children with a mean age of 28.9 months and a mean deviation angle of 34.7 Δ. Patients received 1.2 BT injections. The success rate was 38% at 6 months, 35% at 12 months, and 35% at 24 months. There was 33% transient ptosis and 5% consecutive exotropia. There was no evidence of significant difference in success rate between the transconjunctival and open sky injection methods, baseline angles, age of injection, or type of strabismus.

CONCLUSION

BT injection is effective and safe in pediatric esotropia, regardless of the injection method.

摘要

引言与目的

肉毒杆菌毒素(BT)被用于多种治疗用途,包括斜视治疗。两种注射技术并存——经结膜注射和开放直视注射。本研究的目的是评估BT注射治疗10岁以下儿童内斜视的效果,并比较这两种技术。

患者与方法

这是一项回顾性、单中心研究,纳入了2014年至2017年间通过上述技术接受BT注射以治疗斜视的儿童。记录这些注射的结果,并进行亚组分析(注射技术、年龄、斜视度数、斜视类型)。主要终点是定义为残余斜视小于或等于10三棱镜度(Δ)的最佳成功率。

结果

该研究纳入了68名儿童,平均年龄为28.9个月,平均斜视角度为34.7Δ。患者接受了1.2次BT注射。6个月时成功率为38%,12个月时为35%,24个月时为35%。有33%的患者出现短暂性上睑下垂,5%的患者出现连续性外斜视。没有证据表明经结膜注射和开放直视注射方法、基线角度、注射年龄或斜视类型之间在成功率上存在显著差异。

结论

无论注射方法如何,BT注射在儿童内斜视治疗中都是有效且安全的。

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