Action of Botulinum Toxin on Isometric Contraction of Medial and Lateral Rectus Muscles in Esotropic or Exotropic Patients

Purpose: To study the action of botulinum toxin A on isometric contraction of the medial and lateral rectus muscles in esotropic or exotropic patients. Methods: Isometric contraction in patients with strabismus (exotropic and esotropic) and in volunteers without strabismus was compared 30 days after the use of botulinum toxin A. Results: Findings show that this drug has changed the strength ratio between direct agonist and antagonist muscles. This has promoted the displacement of the point of equilibrium between muscle strengths toward the nasal direction in esotropic cases, toward the temporal direction in exotropic cases, and subsequent deviation of the eye toward its primary position. The average achieved correction was approximately 10 prism diopters in both groups of patients. Conclusion: In both exotropia and esotropia, the average variations in the induced points of equilibrium related to injection of botulinum toxin A were similar. This means that the greatest percentage of corrections happened in cases of small deviations.481384

Validação de escala optométrica regionalizada para pré-escolares: contribuição da enfermagem Validación de una escala optométrica regionalizada para preescolares: contribución de la enfermaría Validation of a regionalized optometric scale for preschool children: nursing contribution

Desenvolveu-se escala de figuras regionalizadas (RAD). Objetivou-se validar a escala, avaliar a correlação entre os coeficientes da acuidade visual, verificar a associação entre os testes e verificar a concordância das medidas. Este é um estudo de validação de tecnologia, experimental, aleatório, triplo-cego, com 246 escolares. Enquanto a sensibilidade foi 88,6 RAD1 e 85,7 RAD2 para o olho direito (OD) e 78,6 e 92,9 para o esquerdo (OE), a especificidade do OD foi 95,3 RAD 1 e 98,1 RAD2 e do OE 97,7 e 98,6, respectivamente. Quanto ao valor preditivo positivo, RAD1 foi 75,6 OD e 81,5 OE e RAD2 88,2 OD e 89,7 OE. Já o valor preditivo negativo em RAD1 foi de 98,0 OD e 97,3 OE e em RAD2 97,6 OD e 99,1 OE. Para correlação e associação no OD e OE, o valor considerado de p = 0,0001. O Alfa de Crombach foi 0,929. Houve significância entre o critério padrão e a escala.<br>Se desarrolló una escala de figuras regionalizadas (RAD). Los objetivos fueron: validar la escala; evaluar la correlación entre los coeficientes de la acuidad visual; verificar la asociación entre las pruebas; y, verificar la concordancia de las medidas. Se trata de un estudio de validación de tecnología, experimental, aleatorio, triple ciego, con 246 escolares. En lo que se refiere a la sensibilidad fue 88,6 RAD1 y 85,7 RAD2 para el ojo derecho (OD), 78,6 y 92,9 para el izquierdo (OE), la especificidad del OD fue 95,3 RAD 1 y 98,1 RAD2 y del OE 97,7 y 98,6. En lo que se refiere al valor predictivo positivo, RAD1 fue 75,6 OD y 81,5 OE y RAD2 88,2 OD y 89,7 OE. Ya el valor predictivo negativo en RAD1 fue de 98,0 OD y 97,3 OE y en RAD 2 97,6 OD y 99,1 OE. Para correlación y asociación en el OD y OE, p = 0,0001. El Alfa de Cronbach fue de 0,929. Hubo significancia entre el criterio estándar y la escala.<br>A regionalized figure scale (RAD) was developed. The objective was to validate the scale, evaluate the correlation between the visual acuity coefficients, verify the association between the tests, and verify the agreement between the measures. This is a triple-blind, experimental, random technology validation study performed on 246 students. Sensitivity was 88.6 RAD1 and 85.7 RAD2 for the right eye (RE), and 78.6 and 92.9 for the left eye (LE), whereas RE specificity was 95.3 RAD1 and 98.1 RAD2, and, 97.7 and 98.6 for the LE, respectively. As for the positive predictive value, RAD1 was 75.6 RE and 81.5 LE, and RAD2 88.2 RE and 89.7 LE. The negative predictive value in RAD1 was 98.0 RE and 97.3 LE, and in RAD2 97.6 RE and 99.1 LE. For the correlation and association in the RE and LE, p=0.0001. Cronbach's Alpha was 0.929. A statistically significant relation was found between the standard criterion and the scale