Dry Eye Disease in Hemifacial Spasm Patients Treated with Botulinum Toxin Type A

Figures & data

Figure 1 Dosage and injection sites of botulinum toxin (Image courtesy of Supanut Apinyawasisuk, MD).

Table 1 Baseline Demographics and Clinical Characteristics

Demographic and Clinical Characteristic	Value (N,%)
Age in years (mean (SD))	61 (10)
Sex
Male (%)	6 (19.4%)
Female (%)	25 (80.6%)
Side of affected eye
Right (%)	17 (54.8%)
Left (%)	14 (45.2%)
Jankovic Rating Scale (JRS)
2	8
3	18
4	5
Number of previous injections of botulinum toxin type A (n)
0 (naïve)	11
1–5	10
6–10	6
>10	4
Duration of treatment in years (median (Q1,Q3))	3 (2,3)
Usage of tear substitutes (%)	17 (54.8%)
OSDI score (median (Q1,Q3))	15.9 (4.50,29.54)

Abbreviations: SD, standard deviation; Q1, first quartile; Q3, third quartile; OSDI score, Ocular Surface Disease Index score (0–100).

Table 2 Comparison of Prevalence and Clinical Parameters Between Affected Eyes (Homolateral Eye) and Non-Affected Eyes (Contralateral Eye) at Baseline

	Homolateral Eye (n = 31)	Contralateral Eye (n = 31)	P
Prevalence of dry eyes (%)	37.93%	27.59%	0.083
TBUT (s), mean (SD)*	5.03 (0.56)	4.77 (0.47)	0.511
Oxford scheme grade (0–5), median (Q1,Q3)^†	0 (0,1)	0 (0,1)	0.031
Schirmer’s test (mm), median (Q1,Q3)^†	11 (5,15)	9.5 (5,15)	0.424
Fluorescein clearance test (FCT)
Basal tear secretion (mm), median (Q1,Q3)^†	3.5 (2,6)	2.75 (1,7)	0.210
Delayed tear clearance (%)^#	24 out of 30 (80%)	20 out of 30 (66.67%)	0.157
Reflex tear (%)^#	21 out of 30 (70%)	20 out of 30 (66.67%)	0.706

Notes: ^†P value by the Wilcoxon signed-rank test; *P value by the Paired samples t-test; ^#P value by McNemar’s test.

Abbreviations: TBUT, tear break-up time; SD, standard deviation.

Table 3 Comparison of Fluorescein Clearance Test (FCT) Between FCT at Baseline and FCT at 1 Month After BTX-A Injection in Homolateral and Contralateral Eye

	Baseline (n= 30)	1-Month Follow-Up (n=27)	P
Homolateral eye
Basal tear secretion (mm), median (Q1,Q3)^†	3.5 (2,6)	5 (1,9)	0.424
Delayed tear clearance (%)^#	20 out of 26 (76.92%)	24 out of 26 (92.31%)	0.103
Reflex tear (%)^#	17 out of 26 (65.38%)	11 out of 26 (42.31%)	0.083
Contralateral eye
Basal tear secretion (mm), median (Q1,Q3)^†	2.75 (1,7)	3 (1,6)	0.308
Delayed tear clearance (%)^#	16 out of 26 (61.54%)	21 out of 26 (80.77%)	0.059
Reflex tear (%)^#	16 out of 26 (61.54%)	17 out of 26 (65.38%)	0.706

Notes: ^†P value by the Wilcoxon signed-rank test; ^#P value by McNemar’s test.

Figure 2 Dry eye parameters at baseline, 1-month, and 3-month after injection of botulinum toxin type A in homolateral and contralateral eyes: (A) tear break-up time of homolateral eyes; (B) tear break-up time of contralateral eyes; (C) Oxford scheme grade of homolateral eyes; (D) Oxford scheme grade of contralateral eyes; (E) Schirmer’s test of homolateral eyes; (F) Schirmer’s test of contralateral eyes.