Aberrações ópticas de alta ordem em pacientes com distonias faciais tratados com toxina botulínica Ocular wavefront aberrations in patients with facial dystonia treated with botulinum toxin

ABSTRACT Purpose: To analyze the ocular wavefront aberrations in patients with facial dystoniatreated with botulinum toxin A.Methods: Patients with benign essential blepharospasm and hemifacial spasm in activityunderwent slit lamp examination and bilateral wavefront analysis under pharmacologicmydriasis using Alcon LADARvision ® wavefront aberrometry system. After that, all patientswere treated with botulinum toxin A injections performed by the same ophthalmologist.After one month, the wavefront analysis was performed in the same way and by the sameexaminer. The main outcome measure was the change in ocular wavefront aberrations.Paired T-test was used to compare pre and post-injection numeric wavefront values.Results: From a total of 11 patients enrolled in this study, 6 (54.5%) had essentialblepharospasm and 5 (45.5%) had hemifacial spasm. The fellow eyes of patients withhemifacial spasm were not included, totalizing 17 eyes with spasm. Eight patients werefemale (72.7%) and three were male (27.3%), the male:female ratio was 1:2.6. The ageranged from 50 to 72 years old with a mean of 65.9 ± 8.2 years. The mean of high orderroot mean square (RMS) wavefront aberrations was 0.68 before and 0.63 one monthafter the treatment (p=0.01). Before the treatment, the mean of spherical aberrationwas 0.23 and decreased to 0.17 one month after the treatment (p=0.01). There was nosignificant difference in the other higher-order aberrations before and after the treatment(p>0.05).Conclusion: The treatment with botulium toxin may decrease spherical aberrations inpatients with facial dystonia.Keywords: Blepharospasm/drug therapy; Hemifacial spasm/drug therapy; Botulinumtoxins, type A/therapeutic use; Dystonia; Facial muscles/physiopathology; Astigmatism/drug therapy; Severity of illness index