{"title":"儿童急性并发性内斜视：临床特征和治疗结果的比较。","authors":"Ying Wang, Jingjing Jiang, Li Li","doi":"10.18502/jovr.v20.14661","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate and compare the clinical features and efficacy of botulinum toxin A (BTX-A) injection versus surgery in acute-onset concomitant esotropia (ACE) in children.</p><p><strong>Methods: </strong>This retrospective comparative clinical study was conducted on 40 children with ACE. The patients were assigned to either the surgery group (<i>n</i> = 23) or the BTX-A group (<i>n</i> = 17). Successful motor outcomes were defined as residual esodeviation of <math><mo><</mo></math> 5 prism diopters (PD), while successful sensory outcomes were defined as the presence of any evidence of sensory fusion or stereopsis.</p><p><strong>Results: </strong>The average treatment age in this study was 7.02 <math><mo>±</mo></math> 3.72 years in the BTX-A group and 6.41 <math><mo>±</mo></math> 2.83 years in the surgery group. There were 5 cases of type I (12.50%), 26 cases of type II (65.00%), and 9 cases of type III (22.50%) for ACE. The deviation before treatment was +(41.35 <math><mo>±</mo></math> 16.90) PD at near and +(39.71 <math><mo>±</mo></math> 14.94) PD at distance in the BTX-A group. In the surgery group, the results were +(49.22 <math><mo>±</mo></math> 18.25) PD at near and +(47.00 <math><mo>±</mo></math> 18.53) PD at distance. After treatment, based on the measured deviation, total motor success was 95.00% (38/40) at near and 90.00% (36/40) at distance. Following treatment, 94.59% (35/37) of patients with ACE exhibited fusion, 86.84% (33/38) had near stereopsis, and 72.97% (27/37) had distance stereopsis. The motor and sensory success rates were not significantly different between the BTX-A and surgery groups. There were no statistically significant differences in motor outcomes or sensory outcomes among the three subtypes of ACE (all <i>P</i> <math><mo>></mo></math> 0.05).</p><p><strong>Conclusion: </strong>In our study, type II was the most common clinical classification for ACE. Favorable outcomes could be achieved with both BTX-A injection and surgery. There was no difference in motor or sensory outcomes regardless of clinical classification. BTX-A injection is minimally invasive, allows early intervention, and may be the preferred approach for managing ACE in children.</p>","PeriodicalId":16586,"journal":{"name":"Journal of Ophthalmic & Vision Research","volume":"20 ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320468/pdf/","citationCount":"0","resultStr":"{\"title\":\"Acute-onset Concomitant Esotropia in Children: A Comparison of Clinical Features and Treatment Outcomes.\",\"authors\":\"Ying Wang, Jingjing Jiang, Li Li\",\"doi\":\"10.18502/jovr.v20.14661\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate and compare the clinical features and efficacy of botulinum toxin A (BTX-A) injection versus surgery in acute-onset concomitant esotropia (ACE) in children.</p><p><strong>Methods: </strong>This retrospective comparative clinical study was conducted on 40 children with ACE. The patients were assigned to either the surgery group (<i>n</i> = 23) or the BTX-A group (<i>n</i> = 17). Successful motor outcomes were defined as residual esodeviation of <math><mo><</mo></math> 5 prism diopters (PD), while successful sensory outcomes were defined as the presence of any evidence of sensory fusion or stereopsis.</p><p><strong>Results: </strong>The average treatment age in this study was 7.02 <math><mo>±</mo></math> 3.72 years in the BTX-A group and 6.41 <math><mo>±</mo></math> 2.83 years in the surgery group. There were 5 cases of type I (12.50%), 26 cases of type II (65.00%), and 9 cases of type III (22.50%) for ACE. The deviation before treatment was +(41.35 <math><mo>±</mo></math> 16.90) PD at near and +(39.71 <math><mo>±</mo></math> 14.94) PD at distance in the BTX-A group. In the surgery group, the results were +(49.22 <math><mo>±</mo></math> 18.25) PD at near and +(47.00 <math><mo>±</mo></math> 18.53) PD at distance. After treatment, based on the measured deviation, total motor success was 95.00% (38/40) at near and 90.00% (36/40) at distance. Following treatment, 94.59% (35/37) of patients with ACE exhibited fusion, 86.84% (33/38) had near stereopsis, and 72.97% (27/37) had distance stereopsis. The motor and sensory success rates were not significantly different between the BTX-A and surgery groups. There were no statistically significant differences in motor outcomes or sensory outcomes among the three subtypes of ACE (all <i>P</i> <math><mo>></mo></math> 0.05).</p><p><strong>Conclusion: </strong>In our study, type II was the most common clinical classification for ACE. Favorable outcomes could be achieved with both BTX-A injection and surgery. There was no difference in motor or sensory outcomes regardless of clinical classification. BTX-A injection is minimally invasive, allows early intervention, and may be the preferred approach for managing ACE in children.</p>\",\"PeriodicalId\":16586,\"journal\":{\"name\":\"Journal of Ophthalmic & Vision Research\",\"volume\":\"20 \",\"pages\":\"\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-07-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320468/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Ophthalmic & Vision Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.18502/jovr.v20.14661\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Ophthalmic & Vision Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18502/jovr.v20.14661","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Acute-onset Concomitant Esotropia in Children: A Comparison of Clinical Features and Treatment Outcomes.
Purpose: To evaluate and compare the clinical features and efficacy of botulinum toxin A (BTX-A) injection versus surgery in acute-onset concomitant esotropia (ACE) in children.
Methods: This retrospective comparative clinical study was conducted on 40 children with ACE. The patients were assigned to either the surgery group (n = 23) or the BTX-A group (n = 17). Successful motor outcomes were defined as residual esodeviation of 5 prism diopters (PD), while successful sensory outcomes were defined as the presence of any evidence of sensory fusion or stereopsis.
Results: The average treatment age in this study was 7.02 3.72 years in the BTX-A group and 6.41 2.83 years in the surgery group. There were 5 cases of type I (12.50%), 26 cases of type II (65.00%), and 9 cases of type III (22.50%) for ACE. The deviation before treatment was +(41.35 16.90) PD at near and +(39.71 14.94) PD at distance in the BTX-A group. In the surgery group, the results were +(49.22 18.25) PD at near and +(47.00 18.53) PD at distance. After treatment, based on the measured deviation, total motor success was 95.00% (38/40) at near and 90.00% (36/40) at distance. Following treatment, 94.59% (35/37) of patients with ACE exhibited fusion, 86.84% (33/38) had near stereopsis, and 72.97% (27/37) had distance stereopsis. The motor and sensory success rates were not significantly different between the BTX-A and surgery groups. There were no statistically significant differences in motor outcomes or sensory outcomes among the three subtypes of ACE (all P 0.05).
Conclusion: In our study, type II was the most common clinical classification for ACE. Favorable outcomes could be achieved with both BTX-A injection and surgery. There was no difference in motor or sensory outcomes regardless of clinical classification. BTX-A injection is minimally invasive, allows early intervention, and may be the preferred approach for managing ACE in children.
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