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Objective demonstration of eyelid spasm relief with smartphone and custom software in hemifacial spasm patients

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Abstract

Purpose

To objectively demonstrate eyelid spasms relief in hemifacial spasm (HFS) patients using a smartphone and a custom-made software.

Methods

Nineteen patients with HFS had standardized videos recorded with a smartphone (iPhone 6S, Apple) camera before and 15 days after receiving onabotulinumtoxinA injections. Nineteen age-matched control subjects were also assessed. The Eye Aspect Ratio (EAR) is an algorithm previously described to determine whether the eye is opened or closed. When the eye is closed, EAR tends to be closer to zero. Analogously, if the eye is wide open, values are greater. A custom-made software using the EAR concept was developed and pre- and post-treatment EARs were analyzed to assess HFS patients.

Results

Botulinum toxin (BoNT) injections led to a significant increase in the average EAR of the affected side: + 10.4% (p = 0.0175) of HFS patients, compared to baseline. Mean EAR before BoNT applications were significantly lower (16.2%) on the affected side (0.25 ± 0.05) of HFS patients when compared to controls (0.30 ± 0.05, p = 0.004). After BoNT injections, no statistically significant difference was observed for the average EAR between the affected side of HFS patients (0.27 ± 0.04) and controls (p = 0.20).

Conclusions

Use of a smartphone and custom-made software objectively demonstrated eyelid spasm relief in patients with HFS. Additional refinement of this system could permit more accurate assessments of treatment response rates for each patient, making it possible to be used in clinical practice.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported in part by Lemann foundation (GRG), IPEPO Vision Institute (GRG) and Coordination for the Improvement of Higher Education Personnel—Brazil (CAPES), Financial Code 001 (GRG and CY).

Author information

Authors and Affiliations

  1. Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, R. Botucatu, 822, 04023-062, São Paulo, SP, Brazil

    Gustavo R. Gameiro, Cristina Yabumoto, Midori H. Osaki, Paulo Schor & Tammy H. Osaki

  2. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA

    Gustavo R. Gameiro

  3. Department of Ophthalmology, University of Santo Amaro (UNISA), São Paulo, SP, Brazil

    Lucas G. Monteiro

  4. Eye & Eyelid Experts, R. Joao Moura, 661, cj 84, 05412-001, São Paulo, SP, Brazil

    Midori H. Osaki & Tammy H. Osaki

Authors
  1. Gustavo R. Gameiro
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  2. Cristina Yabumoto
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  3. Midori H. Osaki
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  4. Lucas G. Monteiro
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  5. Paulo Schor
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  6. Tammy H. Osaki
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Contributions

GRG, MHO, THO contributed to the study conception and design. Data acquisition was performed by GRG, CY, LGM, MHO, THO. Data analysis and interpretation were performed by all authors. The manuscript first draft elaboration was done by GRG. All authors critically reviewed and edited the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Tammy H. Osaki.

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Conflict of interests

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Federal University of São Paulo (EPM/UNIFESP) under number 0534/2018.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent to publish

The authors state that human research participants provided informed consent for publication of the image in Fig. 1, Fig. 2 and Fig. 4.

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This work was presented as a poster at the XXVII Regional Pan-American Congress of Ophthalmology (2024).

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Gameiro, G.R., Yabumoto, C., Osaki, M.H. et al. Objective demonstration of eyelid spasm relief with smartphone and custom software in hemifacial spasm patients. Int Ophthalmol 44, 144 (2024). https://doi.org/10.1007/s10792-024-03070-4

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