Session Information
Date: Thursday, June 23, 2016
Session Title: Clinical trials and therapy in movement disorders
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To describe the improvement in ptosis with apraclonidine in patients with botulinum toxin (BoNT) induced ptosis.
Background: Ptosis is a manifestation of a variety of neurological and medical conditions. Transient ptosis is also a known complication of BoNT injection due to inadvertent migration of toxin into the levator palprebrae muscle. Apraclonidine, α-2 adrenergic receptor agonist, is a topical ophthalmic solution that is primarily used in the treatment of glaucoma. In addition to reducing intraocular pressure, apraclonidine also has the unique ability to elevate the eye lid due to its effect on the superior tarsal or Muller muscle which are smooth muscles innervated by sympathetic nerves. Currently there is no treatment available for BoNT -induced ptosis and typically one has to wait several weeks before the effects of the toxin wears-off for the ptosis to improve.
Methods: Patients with BoNT-induced ptosis were included in the study. Each patient received 2 drops of 0.5 % apraclonidine solution to the ptotic eye and was re-examined 20-30 minutes later. All patients were videotaped before and after the administration of apraclonidine. The degree of ptosis prior to administration was rated 1= mild eye lid droop less than 25% of the palprebal fissure; 2 = moderate eye lid droop 26-50% of the palprebal fissure; 3 = severe eye lid droop >50% of palprebal fissure; 4= complete (100%) ptosis. The degree of improvement following apraclonidine was rated as 0 = no improvement; 1 = mild improvement ≤25% improvement in ptosis; 2 = moderate improvement, 26-50% improvement in ptosis; 3 = marked improvement ≥50% improvement in ptosis; 4 = complete resolution.
Results: Six patients (4 female) with a mean age of 53 years (range 17- 73 years) were included in the study. All 6 patients showed improvement in ptosis. There were 3 patients with mild ptosis: one patient showed marked improvement and 2 patients showed complete or near complete improvement in ptosis. There were 2 patients with moderate ptosis: both showed marked improvement in ptosis. There was one patient with severe ptosis: showed marked improvement in ptosis. There were no adverse effects.
Conclusions: Apraclonidine is an effective treatment option for patients with BoNT-induced ptosis.
To cite this abstract in AMA style:
S. Wijemanne, D. Vijayakumar, J. Jankovic. Apraclonidine in the treatment of ptosis [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/apraclonidine-in-the-treatment-of-ptosis/. Accessed May 18, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/apraclonidine-in-the-treatment-of-ptosis/