ABSTRACT
Purpose: Our study aims at evaluating the efficacy and safety of botulinum toxin A in the early treatment of sixth nerve palsy in type 2 diabetic patients. Methods: This study is a prospective and interventional clinical case series of patients presenting with acute onset of sixth cranial nerve palsy, who received injection botulinum toxin A. Results: Thirty-one cases were included in the study. 58% of the study subjects had incomplete palsy at presentation (abduction deficit -1 to -3) and 42% had complete palsy (-4 and -5). The median dosage of injection was 5 U (range 3--6 U). The median follow-up period is 2 months. The P value shows that there is statistically significant improvement in head turn, ocular deviation in primary position, and improvement in abduction between baseline and 1 week (P-value <0.001), 1 month (P-value <0.001) and 2 month (P-value <0.001) postinjection follow-up visits. 90.3% of patients had full resolution of symptoms in the last follow-up visit. 83.9% of patients were successfully treated. Conclusion: Early injection of botulinum toxin A in select patients with acquired sixth nerve palsy due to diabetes is a safe and efficient treatment option in alleviating symptoms, restoring function and quality of life and reducing need for surgical interventions in future.
ABSTRACT
Purpose: Ocular morbidities like high refractive error, strabismus, and amblyopia are common among laser-treated retinopathy of prematurity children (ROP). Long-term optical status and refractive outcomes including the sensory outcomes were less investigated in these children from this region. The purpose of our study is to evaluate the long-term outcome (refractive, biometric profile, sensory) of treatment for ROP using laser. Methods: This study is a retrospective, cross-sectional, observational, and intervention research among 6–15-year-old children who underwent laser for ROP with a minimum of 6-year follow-up. Results: Eighty lasered eyes of 41 children were assessed. Mean age was 9.71 years (±3.39). Seventy-three eyes (91.2%) achieved visual acuity better than 20/40. The mean visual acuity in LogMAR was 0.18 (20/30). The mean spherical equivalence was ?5.29 D ± 4.9. Mean astigmatism measured was ?1.53 DC (range: +0.50 DC to ?4.5DC). Fifty-three eyes (66.25%) had significant astigmatism. The mean axial length was 23.5 ± 1.35 (21–26) mm. Mean lens thickness was 3.76 ± 0.30 (3.03–4.34) mm. Correlation analysis among the low and high spherical equivalent group signified that axial length (P value = 0.001), visual acuity (P value = 0.0002), and myopic shift (P value = 0.0006) were found to be statistically significant. Stereopsis better than 480 s of arc for near was observed in 41% children. Structural posterior pole sequelae developed in 3 eyes (3.75%). Conclusion: A significant number of children with high myopia, astigmatism, and strabismus had satisfactory visual outcome observed at long-term follow-up after treatment for ROP using laser. Our study revealed that myopia was influenced by an increase in axial length than the lens thickness.