Prognosis of Diabetic Ophthalmoplegia at the Furuyoshi Eye Clinic

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  • 当院における糖尿病眼筋麻痺の予後について

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[Purpose] The prognosis for diabetic ophthalmoplegia is generally good. However, we often encountered cases showing persisting subjective symptoms and micro deviation. In this study, we retrospectively studied the clinical features, prognosis, and risk factors for diabetic ophthalmoplegia.<br>[Subject and Methods] We reviewed (17 eyes of) 14 patients with diabetic ophthalmoplegia diagnosed at the Furuyoshi Eye Clinic between 2004 and 2013. Their ages ranged from 33 to 91 years. We retrospectively evaluated the findings of alternate prism cover test, fusion area measured by the Bagolini striated test, eye movement, and hemoglobin (Hb) A1c levels. The improvement criteria used were those for acquired ocular movement disorders by Fukai et al8). The follow-up duration ranged from 1 month to 2 years.<br>[Results] All 14 patients showed unilateral single neuroparalysis. Recurrence in other nerves was observed in 3 patients. Of the 17 eyes, 7 eyes showed oculomotor nerve palsy, 4 eyes showed trochlear nerve palsy, and 6 eyes showed abducens nerve palsy. Of the 14 patients, 10 (71%) patients had a full recovery and 4 (29%) had a partial recovery. The mean recovery time was 2.6 months. Most of the patients with a partial recovery had been followed up for more than 5 months since the onset of the disease and had a disorder in the inferior and superior rectus muscles with oculomotor nerve palsy. At the time of onset, 11 (79%) of the 14 patients had an HbA1c level higher than 7%. The patients with a partial recovery were mostly seen with an HbA1c level higher than 7%, poor blood sugar control for diabetes, and a diabetes duration for more than 5 years. The onset of ophthalmoplegia also led to the detection of diabetes in 2 patients.<br>[Conclusion] Diabetic ophthalmoplegia was not completely cured in 4/14 (4 (29%) of the 14) subjects. Therefore, we believe that glycemia control may influence the prognosis of diabetic ophthalmoplegia.

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