Evaluation of the use of botulinum toxin type A for strabismus regression: a systematic literature review

Authors

DOI:

https://doi.org/10.33448/rsd-v11i10.32703

Keywords:

Strabismus; Botulinum toxin type A; Acetylcholine.

Abstract

Botulinum toxin (BT) presents itself as a less invasive alternative for the correction of strabismus, acting by the high affinity for cholinergic synapses, which causes a blockage of acetylcholine release. Such application, consequently, causes a lower chemical-neural receptivity, reducing muscle responsiveness to contracture, not causing, however, complete paralysis. Through this mechanism, the injection of botulinum toxin type A (TBA) into the extraocular muscles allows the alteration of ocular alignment creating a temporary paralysis, producing an overcorrection of the strabismus in which a shortening of the antagonist muscle is induced. Histologically, a change in sarcomere density may occur, which favors permanent ocular alignment. In a partial analysis, several authors report good results with the use of TBA in the treatment of different presentations of strabismus. There are several classifications of indication, expected effects, and adverse effects through the procedure, which must be considered upon patient admission. Thus, botulinum toxin, injected intramuscularly, binds to terminal receptors found in motor nerves, acting by blocking the release of acetylcholine in the presynaptic terminal, deactivating fusion proteins, which prevents the release of acetylcholine in the synaptic cleft, which does not allow depolarization of the postsynaptic terminal, blocking muscle contraction by temporary chemical denervation.

References

Benecke, R. (2012). Clinical Relevance of Botulinum Toxin Immunogenicity. Biodrugs, 26 (2), 1-9.

Bicas, H. E. A. (2009). Estrabismos: da teoria à prática, dos conceitos às suas operacionalizações. Arq Bras Oftalmol., 72 (5), 585-615.

Bratz, P. D. E. B. & Mallet, E. K. V. (2015). Toxina botulínica tipo A: abordagens em saúde. Revista Saúde Integrada, 8 (3), 15-18.

Campos, E. C. et al. (2000). Critical age of botulinum toxin treatment in essential infantile esotropia. J Pediatr Ophthalmol Strabismus, 37 (6), 328-332.

Chen, J. et al. (2013). Botulinum toxin injections combined with or without sodium hyaluronate in the absence of electromyography for the treatment of infantile esotropia: a pilot study. Eyes, 27(3), 382-386.

Flores-Reyes, E. M. et al. (2016). Uso de toxina botulínica A en el tratamiento de las endotropías parcialmente acomodativas. Arch Soc Esp Oftalmol., 91 (3), 114–119.

Hexsel, D.M. et al. (2011). Tratado de Medicina Estética: Farmacologia e Imunologia. Editora Roca, 2° Ed., 1113-1121.

Jarrín, E. et al. Aplicaciones clínicas de la toxina botulínica en el estrabismo: estudio de las inyecciones realizadas durante un ano en un hospital general, Arch Soc Esp Oftalmol., 91 (3), 114–119.

Maio, M. & Oliveira, L.G.L. (2011). Tratado de Medicina Estética: Farmacologia e Imunologia. Editora Roca, 2° Ed., 1089-1098.

Merino, P. et al. (2014). Espasmo del reflejo de cerca. Tratamiento con toxina botulínica. Arch Soc Esp Oftalmol., 4 (8), 1-9.

Merino, P. S. et al (2017). Botulinum toxin for treatment of restrictive strabismus. Journal of Optometry, 10 (8), 189-193.

Merino, P. S., et al. (2018). Indications and outcome of vertical rectus partial recessions. Indicaciones y resultados de las recesiones parciales de los rectos verticales. Archivos de la Sociedad Espanola de Oftalmologia, 93 (8), 381–385.

Ribeiro, I. N. S. et al. (2014). O Uso da Toxina Botulínica tipo A nas Rugas Dinâmicas do Terço Superior da Face. Revista da Universidade Ibirapuera, 7 (8), 31-37.

Rowe, F. J. & Noonan, C. P. (2017). Botulinum toxin for the treatment of strabismus (Review). Cochrane Database of Systematic Reviews, 8 (7).

Silva, J. F. N. (2009). A aplicação da toxina botulínica e suas complicações: revisão bibliográfica. Tese de dissertação - Instituto de Ciências Biomédicas de Abel Salazar da Universidade do Porto, 1-134.

Sugano, D. M.; Fernandez, C. L. & Rehder, J. R. C. L. (2013). Uso da toxina botulínica para correção de estrabismo. Rev Bras Oftalmol., 72 (5), 321-325.

Toledo, M. C. et al. (2015). Tratamiento del estrabismo paralítico con toxina botulínica A. Revista Cubana de Oftalmología, 28 (2), 168-176.

Varandas, R. (2007). Toxina Botulínica: Aplicações Terapêuticas em Oftalmologia Pediátrica. Nascer e Crescer, 16 (3), 188-190.

Wattiez, R. et al. (2000). Correção de estrabismo paralítico por injeção de toxina botulínica. Arq. Bras. Oftal., 63 (1).

Xavier, E. C.; Andrade, L. G. & Lobo, L. C. (2021). Toxina botulínica aplicada para fins terapêuticos. Revista Ibero-Americana de Humanidade, Ciências e Educação, 7 (9).

Published

28/07/2022

How to Cite

NOGUEIRA, J. F.; FIGUEIREDO, B. Q. de .; BATISTA, D. H. M.; PINTO, F. O.; GOMES, M. J. de A.; PRESOT, I. Q.; FARIAS, Ítalo G.; TRAVASSO, S. G. A. Evaluation of the use of botulinum toxin type A for strabismus regression: a systematic literature review. Research, Society and Development, [S. l.], v. 11, n. 10, p. e244111032703, 2022. DOI: 10.33448/rsd-v11i10.32703. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/32703. Acesso em: 16 nov. 2024.

Issue

Section

Health Sciences