Quantitative assessment of botulinum toxin injection on blink rate in blepharospasm. 2023

Ghasem Yazdanpanah, and Michael T Yen, and Stephen C Pflugfelder
Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA.

To objectively measure the blink rate in patients with blepharospasm managed by botulinum toxin type-A injections. In this prospective, non-interventional case series, the complete blink rates of subjects were measured before incobotulinumtoxina injection and at follow-up within 4 weeks using slow-motion video-taping. Additionally, subjects graded the frequency of blinking, the severity of light-sensitivity, and the severity and frequency of dry eye symptoms on a categorical visual analog scale. The results are reported as median (range). Ten subjects were enrolled, with nine females. The total duration of treatment was 70 (5-116) months with total of 27.5 (2-51) injections. The subjects were grouped as short-time (<52w) or long-time (>52w) treatments. The median age, follow-up time, and injected doses were 73.5 (49-81) years, 21 (14-28) days, and 38 (8-47) units, respectively, with no significant difference between groups. The total complete blinks per minute before incobotulinumtoxina injection was 39 (23-64) which decreased to 18.5 (1-60) at follow-up (p = 0.004). The average change in complete blink rate was -67.4 ± 23.7% in long-time and -45.2 ± 31.2% in short-time groups (mean ± SD, p = 0.01). The total self-graded frequency of blinking and light-sensitivity decreased significantly at follow-up (p = 0.004, p = 0.047, respectively). Similar patterns of subject reported grades were seen in both groups. Videotaping is a low-cost method for objective measurement of blink rate in blepharospasm patients after incobotulinumtoxina injection. There was a significant reduction in blink rate after incobotulinumtoxina injections with higher percentage of change in the long-time treatment group. Incobotulinumtoxina injection also significantly improves subjective photophobia.

UI MeSH Term Description Entries
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D001764 Blepharospasm Excessive winking; tonic or clonic spasm of the orbicularis oculi muscle. Blepharospasms
D001767 Blinking Brief closing of the eyelids by involuntary normal periodic closing, as a protective measure, or by voluntary action. Orbicularis Oculi Reflex,Reflex, Blink,Reflex, Corneal,Reflex, Orbicularis Oculi,Winking,Blink Reflexes,Corneal Reflexes,Orbicularis Oculi Reflexes,Blink Reflex,Reflexes, Blink,Reflexes, Orbicularis Oculi
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D015352 Dry Eye Syndromes Corneal and conjunctival dryness due to deficient tear production, predominantly in menopausal and post-menopausal women. Filamentary keratitis or erosion of the conjunctival and corneal epithelium may be caused by these disorders. Sensation of the presence of a foreign body in the eye and burning of the eyes may occur. Dry Eye,Dry Eye Disease,Evaporative Dry Eye,Evaporative Dry Eye Disease,Evaporative Dry Eye Syndrome,Dry Eye Diseases,Dry Eye Syndrome,Dry Eye, Evaporative,Dry Eyes,Evaporative Dry Eyes
D019274 Botulinum Toxins, Type A A serotype of botulinum toxins that has specificity for cleavage of SYNAPTOSOMAL-ASSOCIATED PROTEIN 25. Botulinum Neurotoxin Type A,Botulinum Toxin A,Botulinum Toxin Type A,Botox,Botulinum A Toxin,Botulinum Neurotoxin A,Clostridium Botulinum Toxin Type A,Clostridium botulinum A Toxin,Meditoxin,Neuronox,Oculinum,Onabotulinumtoxin A,OnabotulinumtoxinA,Vistabel,Vistabex,Neurotoxin A, Botulinum,Toxin A, Botulinum,Toxin, Botulinum A

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