Botulinum toxin type A in treating early-stage patients with small-angle acute acquired comitant esotropia

AIM:To investigate botulinum toxin A(BTXA)efficacy on small-angle(≤25Δ)acute acquired concomitant esotropia(AACE)in early-stage patients.METHODS:The electronic medical record data of AACE patients during March 2019 and June 2023 were collected in this retrospective and hospital-based cohort study.A total of 72 small-angle AACE patients received BTXA extraocular muscle injection.Patients were grouped by onset-to-treatment time(Group A:≤6mo,Group B:>6mo).Deviation of esotropia,eye alignment and stereopsis were analyzed at the period of pre/post-injection(1wk,1,3,and 6mo).Orthophoria rate at 6mo(horizontal deviation<10Δand binocular single vision)were considered as outcome index.RESULTS:There were no significant baseline differences(P>0.05)between two groups except onset-to-treatment time(2mo vs 11mo,P<0.001).Higher orthophoria rates were in Group A at last follow-up(94.74%vs 73.53%,P=0.013).Post-BTXA deviations of two groups at 1mo showed no difference(P>0.05);while in 3 and 6mo Group A was significantly smaller than group B(all P<0.001).No statistically significant differences were observed among all post-BTXA deviations of near and distance in Group A.In Group B,deviation at 3mo(near:2Δvs 0,P<0.001;distance:4Δvs 0,P<0.001)and 6mo(near:6Δvs 0,P<0.001;distance:6Δvs 0,P<0.001)was significant increased compared to deviation at 1wk after treatment.Group A showed better stereopsis recovery in last follow-up compared to Group B(80″vs 200″,P=0.002).Both groups obtained improved stereopsis after treatment(Group A:80″vs 300″,P<0.001;Group B:200″vs 300″,P=0.037).CONCLUSION:BTXA is effective for AACE with small deviation(≤25Δ)in early stage.Delayed treatment(>6mo)may reduce BTXA efficacy.Early BTXA intervention benefits long-term eye alignment and stereopsis recovery.

Analysis of independent risk factors for acute acquired comitant esotropia

comitant esotropia(AACE).METHODS:A retrospective cohort study was conducted by analyzing 83 patients(case group)with AACE who underwent strabismus correction surgery from January 1,2021 to June 30,2022.Totally 73 outpatient volunteers were recruited during the same period as the normal control group.The case group’s binocular vision time,near and distance esotropia angle,and near stereo vision function were recorded,and the age,gender,refractive status,and best-corrected visual acuity(BCVA)of both groups were analyzed.Additionally,multiple logistic regression analysis was conducted using an eye usage condition questionnaire to determine the independent risk factors for AACE.RESULTS:In the case group,61 patients(73.49%)had myopia,with a mean equivalent spherical power(SE)of-3.35±3.31 D(range:+2.75 to-10.62 D)of the right eye and-2.87±3.35 D(range:+2.75 to-11.12 D)of the left eye.The average duration of diplopia in the case group was 29.83±35.72mo,of which 80 patients(96.39%)were primarily with distance diplopia.The near and distance esotropia angle after wearing glasses were 52.36±20.95 prism degree(PD)and 56.71±19.54 PD,respectively,and there was no statistically significant difference between the two(t=1.38,P=0.169).The incidence of improper glasses wearing and unhealthy eye habits in the case group was significantly higher than those in the control group(P<0.05).Close-up work without glasses[β=2.30,odds ratio(OR)=10,95%confidence interval(CI)2.35-42.51,P=0.002]and near work in supine position(β=1.80,OR=6.02,95%CI 3.29-11.02,P<0.001)were independent risk factors for AACE.CONCLUSION:Patients with AACE mainly present with distance diplopia,and there is a high degree of variation in myopia.Near work without wearing glasses and in supine position are independent risk factors for AACE.

Clinical efflcacy of botulinum toxin type A on acute acquired comitant esotropia

AIM: To investigate the effects of micro-injection of botulinum toxin A(BTXA) on acute acquired comitant esotropia(AACE). METHODS: A total of 33 AACE patients who underwent BTXA micro-injection at Renmin Hospital of Wuhan University from September 1^(st), 2019 to July 1^(st), 2021 were retrospective analyzed. Esotropia, eye alignment, stereopsis, and complications were examined at baseline(except complications), 1wk, 1, 3, and 6mo after injection. RESULTS: The average angle of deviation before injection was(+20.24±6.80)^(Δ) at near and(+24.76±6.43)^(Δ) at distance, while(+5.15±5.85)^(Δ) at near and(+7.30±6.17)^(Δ) at distance 6mo after treatment(P<0.05). Six months after injection, the stereopsis of patients had improved. The number of patients having no stereopsis(>800 seconds of arc) decreased from 11 to 3. The number of patients having peripheral stereopsis(300-800 seconds of arc), macular stereopsis(70-200 seconds of arc) and central concave stereopsis(≤60 seconds of arc) increased from 10 to 11, 10 to 12, and 2 to 7, respectively. At the follow-ups at 1wk, 1, 3, and 6mo after injection, success rates were 96.97%, 96.97%, 93.94% and 87.88%, respectively. One week after injection, two patients(6.07%) showed subconjunctival hemorrhage;three patients(9.09%) showed limited eye movement and one patient(3.03%) showed mild vertical strabismus. All the symptoms disappeared by the final follow-up.CONCLUSION: Micro-injection of BTXA can reduce diplopia and improve binocular vision function of AACE patients. Furthermore, the operation is relatively safe with few complications, making it an ideal treatment modality for AACE.

Altered intrinsic functional connectivity of the primary visual cortex in youth patients with comitant exotropia: a resting state fMRI study

AIM： To evaluate the differences in the functional connectivity（FC） of the primary visual cortex（V1） between the youth comitant exotropia（CE） patients and health subjects using resting functional magnetic resonance imaging（f MRI） data.METHODS： Totally, 32 CEs（25 males and 7 females） and 32 healthy control subjects（HCs）（25 males and 7 females） were enrolled in the study and underwent the MRI scanning. Two-sample t-test was used to examine differences in FC maps between the CE patients and HCs. RESULTS： The CE patients showed significantly less FC between the left brodmann area（BA17） and left lingual gyrus/cerebellum posterior lobe, right middle occipital gyrus, left precentral gyrus/postcentral gyrus and right inferior parietal lobule/postcentral gyrus. Meanwhile, CE patients showed significantly less FC between right BA17 and right middle occipital gyrus（BA19, 37）.CONCLUSION： Our findings show that CE involves abnormal FC in primary visual cortex in many regions, which may underlie the pathologic mechanism of impaired fusion and stereoscopic vision in CEs.

法语中的英语借词及其翻译

“le rock(摇摆舞)、un brushing(卷发、吹发)、un bridge(桥牌)、le steward(男乘务员),un parking(停车场)、le self-control(自我克制)、un walkman(微型收录机或单放机)……”如果我们把日常听到法国人说的英语词罗列出来,其数目确实是令人吃惊的。其实,英语词汇进入法语,较之意大利语、葡萄牙语、西班牙语、阿拉伯语和德语来要晚得多。只是到十八世纪,由于英国在政治、经济、社会、科学等方面逐步领先,再加上法国资产阶级启蒙思想家、法学家孟德斯鸠(Montesquieu),法国启蒙思想家、作家、哲学家伏尔泰(Voltaire)及当时一些百科全书编写者赞同英国的议会制度,使英国的一些政治词汇,如budget(预算)、comité(委员会)、jury(陪审团)、vote(投票)、opposition(反对,反对派)、parlement(议会)等得以在法国流传。