ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
Risk factors and predictors for botulinum toxin type A reinjection within six months in patients with acute acquired concomitant esotropia.
Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTo identify independent risk factors and predictors for botulinum toxin type A (BTA) reinjection within 6 months in acute acquired concomitant esotropia (AACE) patients, providing a scientific foundation for risk-stratified clinical management.
methodsIn this case-control study, AACE patients enrolled at Beijing Tongren Hospital (July 2021-January 2025) receiving initial BTA treatment were categorized into reinjection (n = 56) and nonreinjection (n = 61) groups based on the need for a second injection within 6 months. All participants underwent comprehensive ophthalmic and binocular vision assessments at baseline (T0), 1 month (T1), and 3 months (T2). Binary logistic regression analyses were performed to identify predictors.
resultsBaseline characteristics were comparable between groups, except that anisometropia (≥ 1.0 D) was significantly more prevalent in the reinjection group. Multivariable analysis revealed that baseline anisometropia (≥ 1.0 D) was an independent risk factor for reinjection (OR = 2.789, 95% CI: 1.183-6.576). Incorporating postoperative measures, the dynamic prediction model further identified residual distance deviation at 3 months (T2), measured with full refractive correction, as a significant predictor (OR = 1.315 per prism diopter increase, 95% CI: 1.069-1.619). A prediction model combining these factors achieved an area under the curve of 0.810 (95% CI: 0.732-0.887). A cutoff of > 5.23 prism diopters for residual deviation at T2 predicted reinjection with 82.0% specificity.
conclusionsAnisometropia is a robust baseline predictor for BTA reinjection in AACE. Residual distance deviation at 3 months postoperatively serves as a critical dynamic indicator of treatment response and reinjection risk, enabling early identification of high-risk patients.
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