Retinopathy in patients with diabetic ophthalmoplegia

Lucas Trigler, R. Michael Siatkowski, Angela S. Oster, William J Feuer, Chad L. Betts, Joel S. Glaser, Norman J. Schatz, Bradley K. Farris, Harry W Flynn

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Purpose: To review the clinical characteristics, prevalence, and severity of retinopathy in diabetics with cranial nerve (CN) 3, 4, and/or 6 palsies, and to determine the relationship between type and duration of diabetes mellitus (DM), presence of retinopathy, and occurrence of CN palsy. Design: Retrospective, comparative cohort study. Participants: Chart reviews of 2229 patients with CN 3, 4, and/or 6 palsies were performed at the Bascom Palmer Eye Institute (BPEI) from January 1991 through December 1997 and at the Dean A. McGee Eye Institute (DMEI) from January 1994 through July 2001. A total of 306 patients qualified for the study group. The Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) was used as a control. Methods: Demographic and clinical data were extracted to determine characteristics of patients with diabetic ophthalmoplegia. The subsets of data regarding type of DM and level of diabetic retinopathy in the study population were compared with the WESDR control data for statistical analysis. Main Outcome Measures: The prevalence of diabetic retinopathy in patients with diabetic ophthalmoplegia. Results: Of 2229 patients at both institutions with ocular motor CN palsy, 306 (13.7%) were associated with DM. The frequency of CN involvement was 6 (50.0%), 3 (43.3%), and 4 (6.7%). There was a total of 12 patients (3.9%) with consecutive palsies and 8 patients (2.6%) with simultaneous palsies (5 unilateral and 3 bilateral). At both institutions, the prevalence of retinopathy controlling for duration of DM was lower in both insulin-dependent DM (IDDM) and non-IDDM (NIDDM) type II diabetics as compared with controls (BPEI, P = 0.009 and P = 0.005; DMEI, P = 0.004 and P = 0.29). When data from both locations were combined, the difference was even more significant (IDDM, P = 0.001 and NIDDM, P = 0.006). There were no significant differences between the two institutions in gender, type or duration of DM, age at presentation, or frequency of CN involvement. Conclusions: Diabetic ophthalmoplegia most commonly involves CN 3 and 6, with relative sparing of CN 4. Multiple cranial nerves are affected simultaneously in 2.6% of cases, and consecutive palsies occurred in 3.9% of cases. Type II diabetics with ocular motor CN palsy have significantly less diabetic retinopathy than do controls. This may imply a different pathophysiologic mechanism for these two microvascular complications of DM.

Original languageEnglish
Pages (from-to)1545-1550
Number of pages6
JournalOphthalmology
Volume110
Issue number8
DOIs
StatePublished - Aug 1 2003

Fingerprint

Ophthalmoplegia
Cranial Nerves
Diabetic Retinopathy
Paralysis
Diabetes Mellitus
Cranial Nerve Diseases
Epidemiologic Studies
Statistical Data Interpretation
Diabetes Complications
Type 2 Diabetes Mellitus
Cohort Studies
Demography
Outcome Assessment (Health Care)
Insulin
Population

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Trigler, L., Siatkowski, R. M., Oster, A. S., Feuer, W. J., Betts, C. L., Glaser, J. S., ... Flynn, H. W. (2003). Retinopathy in patients with diabetic ophthalmoplegia. Ophthalmology, 110(8), 1545-1550. https://doi.org/10.1016/S0161-6420(03)00542-6

Retinopathy in patients with diabetic ophthalmoplegia. / Trigler, Lucas; Siatkowski, R. Michael; Oster, Angela S.; Feuer, William J; Betts, Chad L.; Glaser, Joel S.; Schatz, Norman J.; Farris, Bradley K.; Flynn, Harry W.

In: Ophthalmology, Vol. 110, No. 8, 01.08.2003, p. 1545-1550.

Research output: Contribution to journalArticle

Trigler, L, Siatkowski, RM, Oster, AS, Feuer, WJ, Betts, CL, Glaser, JS, Schatz, NJ, Farris, BK & Flynn, HW 2003, 'Retinopathy in patients with diabetic ophthalmoplegia', Ophthalmology, vol. 110, no. 8, pp. 1545-1550. https://doi.org/10.1016/S0161-6420(03)00542-6
Trigler L, Siatkowski RM, Oster AS, Feuer WJ, Betts CL, Glaser JS et al. Retinopathy in patients with diabetic ophthalmoplegia. Ophthalmology. 2003 Aug 1;110(8):1545-1550. https://doi.org/10.1016/S0161-6420(03)00542-6
Trigler, Lucas ; Siatkowski, R. Michael ; Oster, Angela S. ; Feuer, William J ; Betts, Chad L. ; Glaser, Joel S. ; Schatz, Norman J. ; Farris, Bradley K. ; Flynn, Harry W. / Retinopathy in patients with diabetic ophthalmoplegia. In: Ophthalmology. 2003 ; Vol. 110, No. 8. pp. 1545-1550.
@article{72c52e18afc743c5abdfd588b3300a13,
title = "Retinopathy in patients with diabetic ophthalmoplegia",
abstract = "Purpose: To review the clinical characteristics, prevalence, and severity of retinopathy in diabetics with cranial nerve (CN) 3, 4, and/or 6 palsies, and to determine the relationship between type and duration of diabetes mellitus (DM), presence of retinopathy, and occurrence of CN palsy. Design: Retrospective, comparative cohort study. Participants: Chart reviews of 2229 patients with CN 3, 4, and/or 6 palsies were performed at the Bascom Palmer Eye Institute (BPEI) from January 1991 through December 1997 and at the Dean A. McGee Eye Institute (DMEI) from January 1994 through July 2001. A total of 306 patients qualified for the study group. The Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) was used as a control. Methods: Demographic and clinical data were extracted to determine characteristics of patients with diabetic ophthalmoplegia. The subsets of data regarding type of DM and level of diabetic retinopathy in the study population were compared with the WESDR control data for statistical analysis. Main Outcome Measures: The prevalence of diabetic retinopathy in patients with diabetic ophthalmoplegia. Results: Of 2229 patients at both institutions with ocular motor CN palsy, 306 (13.7{\%}) were associated with DM. The frequency of CN involvement was 6 (50.0{\%}), 3 (43.3{\%}), and 4 (6.7{\%}). There was a total of 12 patients (3.9{\%}) with consecutive palsies and 8 patients (2.6{\%}) with simultaneous palsies (5 unilateral and 3 bilateral). At both institutions, the prevalence of retinopathy controlling for duration of DM was lower in both insulin-dependent DM (IDDM) and non-IDDM (NIDDM) type II diabetics as compared with controls (BPEI, P = 0.009 and P = 0.005; DMEI, P = 0.004 and P = 0.29). When data from both locations were combined, the difference was even more significant (IDDM, P = 0.001 and NIDDM, P = 0.006). There were no significant differences between the two institutions in gender, type or duration of DM, age at presentation, or frequency of CN involvement. Conclusions: Diabetic ophthalmoplegia most commonly involves CN 3 and 6, with relative sparing of CN 4. Multiple cranial nerves are affected simultaneously in 2.6{\%} of cases, and consecutive palsies occurred in 3.9{\%} of cases. Type II diabetics with ocular motor CN palsy have significantly less diabetic retinopathy than do controls. This may imply a different pathophysiologic mechanism for these two microvascular complications of DM.",
author = "Lucas Trigler and Siatkowski, {R. Michael} and Oster, {Angela S.} and Feuer, {William J} and Betts, {Chad L.} and Glaser, {Joel S.} and Schatz, {Norman J.} and Farris, {Bradley K.} and Flynn, {Harry W}",
year = "2003",
month = "8",
day = "1",
doi = "10.1016/S0161-6420(03)00542-6",
language = "English",
volume = "110",
pages = "1545--1550",
journal = "Ophthalmology",
issn = "0161-6420",
publisher = "Elsevier Inc.",
number = "8",

}

TY - JOUR

T1 - Retinopathy in patients with diabetic ophthalmoplegia

AU - Trigler, Lucas

AU - Siatkowski, R. Michael

AU - Oster, Angela S.

AU - Feuer, William J

AU - Betts, Chad L.

AU - Glaser, Joel S.

AU - Schatz, Norman J.

AU - Farris, Bradley K.

AU - Flynn, Harry W

PY - 2003/8/1

Y1 - 2003/8/1

N2 - Purpose: To review the clinical characteristics, prevalence, and severity of retinopathy in diabetics with cranial nerve (CN) 3, 4, and/or 6 palsies, and to determine the relationship between type and duration of diabetes mellitus (DM), presence of retinopathy, and occurrence of CN palsy. Design: Retrospective, comparative cohort study. Participants: Chart reviews of 2229 patients with CN 3, 4, and/or 6 palsies were performed at the Bascom Palmer Eye Institute (BPEI) from January 1991 through December 1997 and at the Dean A. McGee Eye Institute (DMEI) from January 1994 through July 2001. A total of 306 patients qualified for the study group. The Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) was used as a control. Methods: Demographic and clinical data were extracted to determine characteristics of patients with diabetic ophthalmoplegia. The subsets of data regarding type of DM and level of diabetic retinopathy in the study population were compared with the WESDR control data for statistical analysis. Main Outcome Measures: The prevalence of diabetic retinopathy in patients with diabetic ophthalmoplegia. Results: Of 2229 patients at both institutions with ocular motor CN palsy, 306 (13.7%) were associated with DM. The frequency of CN involvement was 6 (50.0%), 3 (43.3%), and 4 (6.7%). There was a total of 12 patients (3.9%) with consecutive palsies and 8 patients (2.6%) with simultaneous palsies (5 unilateral and 3 bilateral). At both institutions, the prevalence of retinopathy controlling for duration of DM was lower in both insulin-dependent DM (IDDM) and non-IDDM (NIDDM) type II diabetics as compared with controls (BPEI, P = 0.009 and P = 0.005; DMEI, P = 0.004 and P = 0.29). When data from both locations were combined, the difference was even more significant (IDDM, P = 0.001 and NIDDM, P = 0.006). There were no significant differences between the two institutions in gender, type or duration of DM, age at presentation, or frequency of CN involvement. Conclusions: Diabetic ophthalmoplegia most commonly involves CN 3 and 6, with relative sparing of CN 4. Multiple cranial nerves are affected simultaneously in 2.6% of cases, and consecutive palsies occurred in 3.9% of cases. Type II diabetics with ocular motor CN palsy have significantly less diabetic retinopathy than do controls. This may imply a different pathophysiologic mechanism for these two microvascular complications of DM.

AB - Purpose: To review the clinical characteristics, prevalence, and severity of retinopathy in diabetics with cranial nerve (CN) 3, 4, and/or 6 palsies, and to determine the relationship between type and duration of diabetes mellitus (DM), presence of retinopathy, and occurrence of CN palsy. Design: Retrospective, comparative cohort study. Participants: Chart reviews of 2229 patients with CN 3, 4, and/or 6 palsies were performed at the Bascom Palmer Eye Institute (BPEI) from January 1991 through December 1997 and at the Dean A. McGee Eye Institute (DMEI) from January 1994 through July 2001. A total of 306 patients qualified for the study group. The Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) was used as a control. Methods: Demographic and clinical data were extracted to determine characteristics of patients with diabetic ophthalmoplegia. The subsets of data regarding type of DM and level of diabetic retinopathy in the study population were compared with the WESDR control data for statistical analysis. Main Outcome Measures: The prevalence of diabetic retinopathy in patients with diabetic ophthalmoplegia. Results: Of 2229 patients at both institutions with ocular motor CN palsy, 306 (13.7%) were associated with DM. The frequency of CN involvement was 6 (50.0%), 3 (43.3%), and 4 (6.7%). There was a total of 12 patients (3.9%) with consecutive palsies and 8 patients (2.6%) with simultaneous palsies (5 unilateral and 3 bilateral). At both institutions, the prevalence of retinopathy controlling for duration of DM was lower in both insulin-dependent DM (IDDM) and non-IDDM (NIDDM) type II diabetics as compared with controls (BPEI, P = 0.009 and P = 0.005; DMEI, P = 0.004 and P = 0.29). When data from both locations were combined, the difference was even more significant (IDDM, P = 0.001 and NIDDM, P = 0.006). There were no significant differences between the two institutions in gender, type or duration of DM, age at presentation, or frequency of CN involvement. Conclusions: Diabetic ophthalmoplegia most commonly involves CN 3 and 6, with relative sparing of CN 4. Multiple cranial nerves are affected simultaneously in 2.6% of cases, and consecutive palsies occurred in 3.9% of cases. Type II diabetics with ocular motor CN palsy have significantly less diabetic retinopathy than do controls. This may imply a different pathophysiologic mechanism for these two microvascular complications of DM.

UR - http://www.scopus.com/inward/record.url?scp=0043031199&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0043031199&partnerID=8YFLogxK

U2 - 10.1016/S0161-6420(03)00542-6

DO - 10.1016/S0161-6420(03)00542-6

M3 - Article

C2 - 12917170

AN - SCOPUS:0043031199

VL - 110

SP - 1545

EP - 1550

JO - Ophthalmology

JF - Ophthalmology

SN - 0161-6420

IS - 8

ER -