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Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology 5/2016

10.02.2016 | Oculoplastics and Orbit

Chemodenervation of extraocular muscles with botulinum toxin in thyroid eye disease

verfasst von: David B. Granet, Nickisa Hodgson, Kyle J. Godfrey, Ricardo Ventura, Don O. Kikkawa, Leah Levi, Michael Kinori

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 5/2016

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Abstract

Background

Thyroid eye disease (TED) presents a management dilemma for strabismologists due to the variability of its clinical course. Prisms may be prescribed to relieve diplopia in small deviations. Surgical intervention, on the other hand, should not be done until the active phase of the disease has subsided. We report our experience with chemodenervation utilizing botulinum toxin (BT) injection in the management of TED-related strabismus.

Methods

A retrospective chart review was done on twenty-two (22) consecutive patients receiving BT injections at the University of California, San Diego (UCSD) Thyroid Eye Center. All BT injections were administered by a single physician under electromyographic guidance.

Results

The clinical records of 22 patients (18 females) were reviewed. Seven patients (32 %) had a reduction of their deviation to a point where surgery was not required. In six patients (27 %), surgery was required but an improvement in ocular deviation was found, altering the original surgical plan. In four patients (18 %), the deviation continued to progress after BT injection. Success rates were higher if pre-treatment deviation was less than 20 prism diopters ().

Conclusion

One third of the chemodenervation-treated patients avoided surgical intervention, with an additional 27 % (total of 40 % of those who needed surgery) having a reduced deviation prior to surgery. Using BT injection to extraocular muscles to treat diplopia in TED patients is most effective in preventing surgery in those patients with 20 or less of deviation.
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Metadaten
Titel
Chemodenervation of extraocular muscles with botulinum toxin in thyroid eye disease
verfasst von
David B. Granet
Nickisa Hodgson
Kyle J. Godfrey
Ricardo Ventura
Don O. Kikkawa
Leah Levi
Michael Kinori
Publikationsdatum
10.02.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 5/2016
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-016-3281-6

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