Search

PURPOSE: To explore the efficacy and safety of local injections of dexamethasone into the lateral rectus muscle for treatment of acute idiopathic abducens nerve palsy (AIANP). METHODS: A study group and a control group were established for this study. The former received dexamethasone injections into the paralyzed lateral rectus muscle in combination with oral mecobalamin tablets. The control group only received mecobalamin tablets for no more than two months. The follow-up period was > 6 months. Incidence of lateral rectus palsy and diplopia were recorded, as well as complications. RESULTS: Between September 2019 and September 2022, a total of 72 patients with AIANP were included in this study (mean age: 54.1 ± 15.8 y). After treatment, all 39 patients in the study group were successfully treated (100%), while only 27/33 (81.8%) patients in the control group were successfully treated. This difference between groups was statistically significant (Fisher’s exact test, P = 0.01). Recovery times for the two groups also differed (3.45 ± 1.49 weeks vs. 12.1 ± 9.83 weeks, respectively; P < 0.001). Among the two groups, only one case of conjunctival congestion was reported at the injection site in the treatment group. Furthermore, recurrence was not observed during the follow-up period (17.9 ± 8.17 months). CONCLUSION: Dexamethasone injections into the lateral rectus muscle of AIANP patients are found to be a safe and effective treatment. They also improved the treatment rate and shortened treatment time．

PURPOSE To explore the causes, treatment results, and possible preventive measures of binocular diplopia after cataract surgery METHODS We collected and analyzed the medical history of patients with binocular diplopia after cataract surgery from September 2011 to September 2021in our hospital, including operation type, cause of diplopia, and treatment results. RESULTS We studied 12 patients (average age, 73.7 ± 7.32 years) having developed diplopia after cataract surgery. Diplopia was explained in six cases by fusion weakness, three cases by incomplete extraocular paralysis, two cases by acquired central fusion disruption caused by perceptual exotropia, and one case by sensory fusion disruption. According to different etiologies, convergence exercises, hormone and vitamin therapy, and strabismus surgery were the approaches taken. Six cases (50%) recovered from diplopia, two (16.6%) showed improvement, and four (33.3%) showed treatment failure. CONCLUSION Decompensation of preexisting asymptomatic strabismus has become the main cause of binocular diplopia after cataract surgery. Improving the understanding of these diseases and their careful examination and reasonable treatment can reduce the extent of diplopia after cataract surgery to a certain extent, but it is difficult to completely eliminate it.

BackgroundThe treatment efficacy of botulinum toxin bilateral medial rectus injections for acute acquired concomitant esotropia (AACE) in adult is not clear. We characterize the effects of botulinum toxin injection in the treatment of AACE, especially in patients over 14 years old, and compared it with surgical treatment.MethodsIn this prospective, nonrandomized, controlled clinical study, patients with AACE in our hospital from March 2017 to March 2020 elected to receive bilateral medial rectus injections of botulinum toxin or to undergo extraocular muscle surgery. Ocular position and stereopsis were evaluated before and after treatment.ResultsA total of 60 patients were treated: 40 patients in the botulinum toxin group, and 20 patients in the surgery group. The botulinum toxin group included 31 cases ≥ 14 years of age and 9 cases P > 0.05).ConclusionThe injection of botulinum toxin has a good effect on AACE in adults and children. The outcomes achieved with injected botulinum toxin are similar to those achieved with surgery.Trial registrationChiCTR,ChiCTR2000032544. Registered May 2, 2020, Retrospectively registered.

Background At present, patients with ocular myasthenia gravis (OMG) are typically treated with systemic drugs. We investigated the use of dexamethasone injected in the peribulbar region or extraocular muscle to treat patients with OMG. Methods Patients with OMG were given dexamethasone via peribulbar injection or direct injection into the main paralyzed extraocular muscles, once a week, for 4–6 weeks. The severity of diplopia, blepharoptosis, eye position, and eye movement were evaluated before and after treatment. The duration of follow-up time was ≥6 months. Results Among the 14 patients with OMG who received this treatment, mean age was 38.7 ± 29.7 years. After treatment, symptoms were relieved in 12 patients (85.7%), 1 patient (7.1%) had partial response to treatment, and 1 patient (7.1%) had no response. Two patients (14.2%) experienced symptom recurrence during the follow-up period. Conclusions Dexamethasone peribulbar or extraocular muscle injection is effective in the treatment of patients with OMG and may replace systemic drug therapy. Trial registration Chinese Clinical Trial Registry, ChiCTR2000038863, October 7, 2020.Retrospectively registered.

BackgroundTo explore the application value of optical coherence tomography angiography (OCTA) in patients with strabismus amblyopia accompanied by eccentric fixation.MethodsThe following data were collected from patients with strabismus amblyopia accompanied by eccentric fixation: best corrected visual acuity (BCVA); spherical equivalent (SE) and deviation angle; eccentric fixation distance using OCTA system software tools, with µm as the unit of measurement of the distance between the retinal fixed point and the macular fovea; macular fovea vessel length density (VLD); perfusion density (PD); foveal avascular zone (FAZ) area; and perimeter and circularity of the superficial retinal vascular plexus. The entry criteria were as follows: OCTA scanning quality and signal strength of 8 or above (range 0 to 10).ResultsData from a total of 34 patients were collected: 17 patients with strabismus amblyopia with eccentric fixation were included in the experimental group, and 17 patients without strabismus with central fixation were included in the control group. The average deviation angle of the experimental group was 26.71 ± 25.88 prism dioptres (PD), the amblyopic eye BCVA was 0.24 ± 0.22, the SE was 4.35 ± 2.98 D, the stereoscopic median was 800", the eccentric fixation distance was 632.18 ± 310.62 µm, the macular fovea retinal thickness was 207.82 ± 17.79 µm, the VLD of the superficial retinal vascular plexus was 7.31 ± 3.84 mm− 1, the PD was 0.16 ± 0.08, the FAZ area was 0.28 ± 0.17 mm2, the FAZ perimeter was 2.05 ± 0.56 mm, and the FAZ circularity was 0.67 ± 0.06. These results showed statistically significant differences in the SE and BCVA compared with the lateral eye and the control group, but there were no statistically significant differences in the macular fovea retinal thickness, VLD, PD, or FAZ. The eccentric fixation of amblyopic eyes was directly related to the deviation angle, and the regression formula was as follows: the eccentric fixation distance of amblyopic eyes = 8.319 × the deviation angle + 410.002 (F = 13.878, P = 0.002

Table S1. The Summary of patient characteristics and injection sites. (DOCX 13 kb)