Joint treatment of severe amblyopia combined with uncomfortable esotropia (case report)

2021 ◽  
pp. 136-138
Author(s):  
G.V. Muraveva ◽  
◽  
A.A. Vydrina ◽  
Keyword(s):  
Botulinum Toxin Type A ◽  
Rectus Muscle ◽  
Botulinum Toxin Type ◽  
Oblique Muscle ◽  
Deviation Angle ◽  
Inferior Oblique Muscle ◽  
Second Stage ◽  
Forced Turn ◽  
The Right ◽  
Gaze Position

Purpose - to evaluate the effectiveness of a joint method for the treatment of severe amblyopia, combined with uncomfortable esotropia, including chemodenervation of the extraocular muscle and subsequent pleoptic treatment using the «Ambliokor» medical complex. Material and methods. The patient is 3 years old. Diagnosis: unfriendly non-paralytic esohypertropia with a prevalence of OD; amblyopia, severe OD, moderate OS, mixed astigmatism OU. The treatment was carried out in 2 stages. At the first stage in order to eliminate the dysbinocular factor of amblyopia, chemodenervation of the internal rectus muscle of the right eye with the preparation of botulinum toxin type A «Botox» was performed by the intraoperative technique. After 1 month, at the second stage, a complex pleoptic treatment was carried out. Results. After chemodenervation, 1 month later, orthotropy in the primary gaze position without glasses and with glasses was achieved. The vertical deviation significantly decreased to 5 degrees in the position of adduction of the eyeballs. The right lead was restored fully. The forced turn of the head was eliminated. After the third course of complex pleoptic treatment, visual acuity with correction was 0.7 on the right and 0.8 on the left. Restoration of central visual fixation in the right eye was noted. The simultaneous nature of vision was revealed. The deviation angle of the eyes in the primary gaze position without glasses and with glasses to the nose did not exceed +7 degrees according to Hirshberg. Hypertropia persisted in adduction up to 10 degrees according to Hirschberg (hyperfunction of the inferior oblique muscle) in both eyes. «V»-syndrome persisted. The patient is planned to surgically weaken the hyperfunction of the inferior oblique muscle of both eyes, followed by the continuation of a complex of pleopto-orthoptic treatment. Conclusion. The existing extensive base of various methods of influencing the functions of the amblyopic eye allows for successful treatment of even severe amblyopia. Key words: amblyopia, unfriendly esotropia, chemodenervation, pleoptic treatment.

Features of surgical treatment of Brown's syndrome in children

2021 ◽  
pp. 11-16
Author(s):  
N.A. Malinovskaya ◽  
◽  
E.V. Semyonova ◽  
A. Toriya ◽  
P.A. Nikonorova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Binocular Vision ◽  
Rectus Muscle ◽  
Oblique Muscle ◽  
Double Vision ◽  
Inferior Rectus ◽  
Inferior Oblique Muscle ◽  
Straight Position ◽  
Third Stage

Purpose. To study the features of surgical treatment of Brown's syndrome in children. Material and methods. 47 children with Brown's syndrome aged from one to 10 years were treated: 4 children had bilateral form, 43 had congenital form and 4 had acquired form. The operation was performed for 44 children. The indications for surgical treatment were double vision in a straight position, forced position of the head, impaired binocular vision. Results. Three children with acquired Brown's syndrome had a positive effect on the background of conservative treatment. Surgical treatment of Brown's syndrome was effective, but often required repeated interventions (31 patients, 70%): the first stage was weakening of the superior oblique muscle (tenotomy, recession, prolongation), the second stage was recession of the inferior oblique muscle, the third stage was recession of the contralateral inferior rectus muscles (4 patients, 9%). In a number of cases (5 children, 11%), at the outcome of surgical treatment, asymmetry of the palpebral fissures was noted due to mild enophthalmos in the operated eye (the result of weakening of the oblique muscles that «pull» the eyes out of the orbit and weakening of the contralateral inferior rectus muscle that «tightens» the eyeball). Conclusion. Surgery for Brown's syndrome is effective, but often requires reoperation. With acquired forms of Brown's syndrome, examination and the first stage of conservative treatment are required. The absolute indications for surgical treatment of Brown's syndrome are forced head position, double vision in a straight position and impaired binocular vision. Keywords: Brown's syndrome, double vision in a straight position, forced position of the head, impaired binocular vision, surgical treatment.

scholarly journals Botulinum toxin type A for the treatment of muscle contractures secondary to acute spinal cord injury in a young cat

2020 ◽  
Vol 6 (1) ◽  
pp. 205511692092264
Author(s):  
Robert I McGeachan ◽  
Tobias Schwarz ◽  
Danièlle A Gunn-Moore ◽  
Katia Marioni-Henry
Keyword(s):  
Spinal Cord ◽  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Clinical Signs ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Subacute Stroke ◽  
Thoracic Limb ◽  
Cord Injury ◽  
The Right

Case summary A 4-month-old male entire domestic shorthair cat presented for sudden onset of right thoracic monoparesis following a fall; within 18 h, the clinical signs progressed to non-ambulatory right hemiplegia with absent sensation in the distal right thoracic limb and left hemiparesis. MRI revealed changes consistent with a C6–C7 acute non-compressive nucleus pulposus extrusion with suspected secondary C5–C7 spinal cord haemorrhage. Rehabilitation exercises were started immediately after the diagnosis of acute spinal cord trauma. Sensation in the right thoracic limb improved and, with the help of a splint applied to that limb, the cat was ambulatory on all four limbs. Unfortunately, clinical signs started to progress over the course of 10 days. The cat developed progressive discomfort on manipulation of the right elbow and carpus, and a hyperflexion of the right carpus. Radiographs revealed no skeletal abnormalities. Muscle contractures were suspected. Under general anaesthesia the triceps and flexor muscles of the carpus and digits were injected with a total of 100 U of botulinum toxin type A (BTX-A). No complications were associated with the procedure and 24 h after the injection the carpal hyperflexion resolved. Relevance and novel information The use of BTX-A to treat muscle contractures in human medicine is an established and increasingly used technique. For example, in subacute stroke patients with a non-functional arm, BTX-A forearm injection appears to prevent disabling finger stiffness, likely by minimising the development of contractures. Here, we demonstrate that intramuscular BTX-A is an effective treatment for acquired muscle contractures in a cat.

scholarly journals Three-dimensional assessment of enamel and dentine in mouse molar teeth during masseter muscle hypofunction

2019 ◽  
Vol 26 (2) ◽  
pp. 30-37 ◽  
Author(s):  
Julián Balanta-Melo ◽  
Maximilian Bemmann ◽  
Viviana Toro Ibacache ◽  
Kornelius Kupczik ◽  
Sonja Buvinic
Keyword(s):  
Root Length ◽  
Ex Vivo ◽  
Botulinum Toxin Type A ◽  
Three Dimensional ◽  
Botulinum Toxin Type ◽  
Contralateral Side ◽  
Control Group ◽  
Adult Mice ◽  
Molar Teeth ◽  
The Right

Background: Mouse molar is a widely used model for teeth development. However, the effect of masticatory function on enamel and dentine in adult individuals remains poorly understood. As reported, the unilateral masseter hypofunction induced by botulinum toxin type A (BoNTA) resulted in mandibular bone damage and signs of unilateral chewing in adult mice. Objective: We aimed to assess the amount of enamel and dentine in the first molar (M1) during the unilateral masseter hypofunction in mice, using high-resolution X-ray microtomography (μCT) as threedimensional approach. Materials and methods: Mandibles of adult BALB/c mice, located either in a Control-group (without intervention) or a BoNTA-group, were ex-vivo scanned using μCT. Treated individuals received each one BoNTA intervention in the right masseter, and saline solution in the left masseter (intra-individual control). Enamel and dentine from M1 were segmented, and volume, thickness and mesial root length were quantified. Results: Enamel volume from treated side resulted unchanged after 2 weeks of unilateral masseter hypofunction. No differences for enamel volume were found between both sides of control individuals, and between these and samples from hypofunctional side in BoNTA-group. Enamel volume from saline-injected side was reduced when compared with experimental side (p<0,01). No differences in dentine volume, thickness of enamel and dentine, and mesial root length were found for any group. Conclusion: The amount of enamel in hypofunctional molars remains unaffected after unilateral BoNTA intervention in the masseter, but contralateral side showed reduced enamel volume. Therefore, increased functional wearing during unilateral chewing after BoNTA intervention should be considered.

Extraocular Muscle Pathology in Aperts Syndrome

1977 ◽  
Vol 35 ◽  
pp. 540-541
Author(s):  
Bruce R. Pachter ◽  
Shelia Margolis ◽  
Jacob Davidowitz ◽  
Goodwin M. Breinin
Keyword(s):  
Phosphate Buffer ◽  
Extraocular Muscle ◽  
Osmium Tetroxide ◽  
Oblique Muscle ◽  
Muscle Pathology ◽  
Structural Abnormality ◽  
Ocular Motility ◽  
Electron Microscopic ◽  
Inferior Oblique Muscle ◽  
The Right

Aperts disease or Acrocephalosyndactyly described by Apert1 consists of oxycephaly (tower skull), exophthalmos, strabismus, antimongloid fissures, syndactyly (fusion of fingers, 2-4). This syndrome frequently involves ocular motility disturbances.: the latter have been suggested to result from mechanical limitations of the globe which are secondary to the bony malformation of the orbit2. Up until this time the question of a structural abnormality existing in the extraocular muscles themselves has not been investigated. The present light and electron microscopic study examined a segment of the inferior oblique muscle taken from a patient with Aperts syndrome.The right inferior oblique muscle from a patient with Aperts syndrome was completely disinserted and an 8mm segment was taken from its belly portion. The specimen was fixed initially in 1% paraformaldehyde-1% glutaraldehyde in phosphate buffer for 4 hrs, then transferred to 4% glutaraldehyde overnight. The muscle segment was postfixed in 1% osmium tetroxide, dehydrated in graded alcohols, embedded whole in Epon 812, and serially sectioned at 15 microns.

Bilateral congenital hypertropic strabismus fixus: A case report

2021 ◽  
pp. 112067212098636
Author(s):  
Qingji Li ◽  
Feng Zhou ◽  
Yingying Lu
Keyword(s):  
Case Report ◽  
Special Form ◽  
Rare Case ◽  
Infratemporal Fossa ◽  
Rectus Muscle ◽  
Oblique Muscle ◽  
Bony Landmark ◽  
Inferior Oblique Muscle ◽  
Muscle Belly

Purpose: To report an unusual and rare case of both eyes fixed in an extreme superomedial position. Case report: A case of 48-year-old woman presented with both eyes fixed in an extreme superomedial position; the microcorneas were covered almost completely by the upper eyelids even when she opened her eyes. A forced duction test was performed to confirm there were severe restrictions in all directions. She underwent disinsertion of the superior and medial rectus muscle, inferior oblique muscle belly transposition and sclera fixation. At the 1-year follow-up, there was improved ocular alignment. Conclusion: This case may be a special form of myopic strabismus fixus. The infratemporal fossa may be a bony landmark related to the etiology of global fixation.

scholarly journals Clinical Aspects of Prevention and Management of Primary Inferior Oblique Muscle Overaction

2019 ◽  
Vol 4 (4) ◽  
pp. 77-82
Author(s):  
I. L. Plisov ◽  
V. B. Pushchina ◽  
N. G. Antsiferova ◽  
G. V. Gladysheva ◽  
D. R. Mamulat ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Rectus Muscle ◽  
Functional Results ◽  
Oblique Muscle ◽  
Clinical Aspects ◽  
Inferior Oblique Muscle ◽  
Infantile Esotropia ◽  
Group 2 ◽  
Clinically Significant ◽  
Group 1

Background. Primary inferior oblique muscle overaction (PIOOA) may occur for various reasons and happens to 72 % patients with infantile esotropia. The criterion for the first surgical step is prevalence of vertical or horizontal deviation. The choice of tactics weakening inferior oblique muscle is ambiguous.Aims: to carry out retrospective analysis of PIOOA frequency in patients with infantile esotropia; to assess influence of esodeviation reduction by a surgical, chemodenervational or prismatic method on the existing PIOOA dynamics; to assess clinical and functional results of PIOOA treatment.Methods and methods. The retrospective analysis of 572 patients’ cases lay in assessment of PIOOA frequency and rate in patients with infantile esotropia that manifested under 9 months, with different treatment tactics. The prospective part of the research included two groups of patients. Group 1 (106 patients, 222 eyes) – studying the influence of surgical treatment of PIOOA. Group 2 (127 patients, 207 eyes) – studying the effectiveness of surgical PIOOA treatment. Conclusion. PIOOA frequency in case of different treatment tactics for patients with infantile esotropia is from 17 to 69 %, and the degree of its clinical manifestation is from 1.2 ± 0.4 to 2.6 ± 0.8. Bilateral weakening of medial rectus muscle reduces its probability up to 17–19 %, and the degree of its manifestation up to 1.2 ± 0.4. In cases of combination of PIOOA with infantile esotropia from 20 to 25° with paretic component, it is reasonable to carry out esodeviation reduction by means of bilateral recession, chemorecession or prismatic correction as the first treatment stage, whereas the rate of existing PIOOA is credibly reduced. In cases of choice of tactics, which is necessary for clinically significant reduction or elimination of PIOOA, it is reasonable to carry out chemorecession, marginal partial myotomy or myectomy depending on the PIOOA manifestation.

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