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Klin Monbl Augenheilkd 2018; 235(04): 465-468
DOI: 10.1055/s-0043-125060
Kasuistik
Georg Thieme Verlag KG Stuttgart · New York

Botulinum Toxin for the Treatment of Cyclic Strabismus in Children: Three Case Reports

Botulinumtoxin in der Therapie des zyklischen Innenschielens bei Kindern: 3 Fallberichte
Monika Wipf
1   Ophthalmology, University Eye Hospital, Basel, Switzerland
,
Corinne Bok-Beaube
2   Ophthalmology, Hospital Fribourgeoise, Fribourg, Switzerland
,
Anja Palmowski-Wolfe
1   Ophthalmology, University Eye Hospital, Basel, Switzerland
› Author Affiliations
Further Information

Publication History

received 06 September 2017

accepted 17 November 2017

Publication Date:
16 February 2018 (online)

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Abstract

Cyclic strabismus is a rare disease of unknown origin. If untreated, it leads to manifest strabismus with the risk of amblyopia in children. Treatment is generally surgical. Here we report on three children in whom cyclic esotropia was successfully treated with one bimedial injection of 5 IU Botox®. All patients remained orthotropic with good stereo functions at the last follow-ups at 16, 11, and 8 months. Botulinum toxin offered a minimally invasive treatment option in these patients.

Zusammenfassung

Zyklisches Schielen ist eine seltene Form des Strabismus, die unbehandelt zum manifesten Schielen führt. Hier berichten wir über 3 Kinder, bei denen die Injektion von Botulinumtoxin in beide Mm. rectus medialis zu einer Heilung führte, die auch beim letzten Besuch nach 16, 11 und 8 Monaten anhielt. Somit bietet Botulinumtoxin eine minimalinvasive Therapieoption bei zyklischen Schielformen im Kindesalter.

Key words

pediatric ophthalmology - strabisms - cyclic strabismus - botulinum toxin

Schlüsselwörter

Kinderophthalmologie - Strabologie - zyklisches Innenschielen - Botulinumtoxin
 

  • References

  • 1 Kaufmann H. Strabismus. 3. Aufl.. Stuttgart: Thieme; 2004
    Google Scholar
  • 2 Buch H, Vinding T. Acute acquired comitant esotropia of childhood: a classification based on 48 children. Acta Ophthalmol 2015; 93: 568-574
    CrossrefPubMedGoogle Scholar
  • 3 Ngo CS, Araya MP, Kraft SP. Cyclic strabismus in adults. J AAPOS 2015; 19: 279-281
    CrossrefPubMedGoogle Scholar
  • 4 Hess JE. Cyclic esotropia – a case history. Am Orthopt J 1974; 24: 83-85
    CrossrefPubMedGoogle Scholar
  • 5 Chamberlain W. Cyclic esotropia. Am Orthopt J 1968; 18: 31-34
    PubMedGoogle Scholar
  • 6 Kee C, Hwang JM. Accommodative esotropia decompensated to cyclic esotropia in a 6-year-old boy. J AAPOS 2014; 18: 77-78
    CrossrefPubMedGoogle Scholar
  • 7 Dawson E, Adams G, Mengher L. et al. Alternate day exotropia. Strabismus 2009; 17: 171-174
    CrossrefPubMedGoogle Scholar
  • 8 Hutcheson KA, Lambert SR. Cyclic esotropia after a traumatic sixth nerve palsy in a child. J AAPOS 1998; 2: 376-377
    CrossrefPubMedGoogle Scholar
  • 9 Metz HS, Jampolsky A. Alternate day esotropia. J Pediatr Ophthalmol Strabismus 1979; 16: 40-42
    PubMedGoogle Scholar
  • 10 Wang X, Chen B, Liu L. Cyclic esotropia with development of a high accommodative convergence to accommodation ratio after surgery for intermittent exotropia. Int Ophthalmol 2016; 37: 1069-1072
    PubMedGoogle Scholar
  • 11 Muchnick RS, Sanfilippo S, Dunlap EA. Cyclic esotropia developing after strabismus surgery. Arch Ophthalmol 1976; 94: 459-460
    CrossrefPubMedGoogle Scholar
  • 12 Uemura Y, Tomita M, Tanaka Y. Consecutive cyclic esotropia. J Pediatr Ophthalmol 1977; 14: 278-280
    PubMedGoogle Scholar
  • 13 Stager jr. D, Thyparampil PJ, Stager sr. DR. Cyclic exotropia in a child. J AAPOS 2010; 14: 553-554
    CrossrefPubMedGoogle Scholar
  • 14 Ma L, Kong D, Fan Z, Zhao J. Consecutive cyclic esotropia after surgery for intermittent exotropia. Can J Ophthalmol 2014; 49: e107
    CrossrefPubMedGoogle Scholar
  • 15 Pillai P, Dhand UK. Cyclic esotropia with central nervous system disease: report of two cases. J Pediatr Ophthalmol Strabismus 1987; 24: 237-241
    PubMedGoogle Scholar
  • 16 Hyvärinen L, Näsänen R, Laurinen P. New visual acuity test for pre-school children. Acta Ophthalmol (Copenh) 1980; 58: 507-511
    PubMedGoogle Scholar
  • 17 Aichmair H. [Cyclic esotropia (alternate day squint)]. Wien Klin Wochenschr 1977; 89: 133-135
    PubMedGoogle Scholar
  • 18 Helveston EM. Surgical treatment of cyclic esotropia. Am Orthopt J 1976; 26: 87-88
    CrossrefPubMedGoogle Scholar
  • 19 Di Meo A, Costagliola C, Della Corte M. et al. Adult-onset cyclic esotropia: a case report. Optom Vis Sci 2013; 90: e95
    CrossrefPubMedGoogle Scholar
  • 20 Pott JW, Godts D, Kerkhof DB. et al. Cyclic esotropia and the treatment of over-elevation in adduction and V-pattern. Br J Ophthalmol 2004; 88: 66-68
    CrossrefPubMedGoogle Scholar
  • 21 Cahill M, Walsh J, McAleer A. Recurrence of cyclic esotropia after surgical correction. J AAPOS 1999; 3: 379-380
    CrossrefPubMedGoogle Scholar
  • 22 Mahan M, Engel JM. The resurgence of botulinum toxin injection for strabismus in children. Curr Opin Ophthalmol 2017; 28: 460-464
    CrossrefPubMedGoogle Scholar
  • 23 Ameri A, Mirmohammadsadeghi A, Makateb A. et al. Clinical outcomes of botulinum toxin injection in patients with cerebral palsy and esotropia. Strabismus 2015; 23: 8-13
    CrossrefPubMedGoogle Scholar
  • 24 Ing MR. Botulinum alignment for congenital esotropia. Trans Am Ophthalmol Soc 1992; 90: 361-371
    PubMedGoogle Scholar
  • 25 Ing MR. Botulinum alignment for congenital esotropia. Ophthalmology 1993; 100: 318-322
    CrossrefPubMedGoogle Scholar
  • 26 Ing MR. Botulinum toxin treatment of infantile esotropia in children. Arch Ophthalmol 1998; 116: 833
    PubMedGoogle Scholar
  • 27 Kushner BJ. Botulinum toxin management of essential infantile esotropia in children. Arch Ophthalmol 1997; 115: 1458-1459
    CrossrefPubMedGoogle Scholar
  • 28 Lee J, Elston J, Vickers S. et al. Botulinum toxin therapy for squint. Eye (Lond) 1988; 2: 24-28
    CrossrefPubMedGoogle Scholar
  • 29 Magoon E, Scott AB. Botulinum toxin chemodenervation in infants and children: an alternative to incisional strabismus surgery. J Pediatr 1987; 110: 719-722
    CrossrefPubMedGoogle Scholar
  • 30 Magoon EH. Botulinum toxin chemo-denervation for strabismus in infants and children. J Pediatr Ophthalmol Strabismus 1984; 21: 110-113
    PubMedGoogle Scholar
  • 31 Magoon EH. Chemodenervation of strabismic children. A 2- to 5-year follow-up study compared with shorter follow-up. Ophthalmology 1989; 96: 931-934
    CrossrefPubMedGoogle Scholar
  • 32 McNeer KW, Tucker MG, Spencer RF. Botulinum toxin management of essential infantile esotropia in children. Arch Ophthalmol 1997; 115: 1411-1418
    CrossrefPubMedGoogle Scholar
  • 33 McNeer KW, Tucker MG, Spencer RF. Botulinum toxin therapy for essential infantile esotropia in children. Arch Ophthalmol 1998; 116: 701-703
    PubMedGoogle Scholar
  • 34 Noguera H, Castiella Acha JC, Anguiano Jimenez M. Medical and surgical treatment of primary divergent strabismus. Arch Soc Esp Oftalmol 2014; 89: 431-438
    CrossrefPubMedGoogle Scholar
  • 35 Rayner SA, Hollick EJ, Lee JP. Botulinum toxin in childhood strabismus. Strabismus 1999; 7: 103-111
    CrossrefPubMedGoogle Scholar
  • 36 Scott AB, Magoon EH, McNeer KW. et al. Botulinum treatment of strabismus in children. Trans Am Ophthalmol Soc 1989; 87: 174-184
    PubMedGoogle Scholar
  • 37 Scott AB, Magoon EH, McNeer KW. et al. Botulinum treatment of childhood strabismus. Ophthalmology 1990; 97: 1434-1438
    CrossrefPubMedGoogle Scholar
  • 38 Tejedor J, Rodriguez JM. Early retreatment of infantile esotropia: comparison of reoperation and botulinum toxin. Br J Ophthalmol 1999; 83: 783-787
    CrossrefPubMedGoogle Scholar
  • 39 McNeer KW, Tucker MG. Bilateral simultaneous lateral rectus botox injection in infant and childhood intermittent exotropia. J AAPOS 2013; 17: e7
    PubMedGoogle Scholar
  • 40 Jones A, Jain S. Botulinum toxin: a novel treatment for pediatric cyclic esotropia. J AAPOS 2014; 18: 614-615
    CrossrefPubMedGoogle Scholar
  • 41 Lai YH, Fredrick DR. Alteration of cyclic frequency by botulinum toxin injection in adult onset cyclic esotropia. Br J Ophthalmol 2005; 89: 1540-1541
    CrossrefPubMedGoogle Scholar
  • 42 Tapiero B, Pedespan JM, Rougier MB. et al. [Cyclic strabismus. Presentation of two new cases and critical review of the literature]. J Fr Ophtalmol 1995; 18: 411-420
    PubMedGoogle Scholar
  • 43 Voide N, Presset C, Klainguti G. et al. Nonsurgical treatment of cyclic esotropia. J AAPOS 2015; 19: 196-198
    CrossrefPubMedGoogle Scholar