Clinical Manifestations in Diabetics with Retinopathy and Ophthalmoplegia

Abstract

Eleven patients with concomitant diabetic ophthalmoplegia and diabetic retinopathy were retrospectively studied. Six of the patients (55%) were afflicted with the oculomotor nerve palsy and five (45%) were afflicted with abducens nerve palsy. Two of the patients (18%) had recurrence of ophthalmoplegia 4 and 6 years after the first attack, respectively. All patients recovered completely from their cranial nerve palsies. The blood glucose levels were poorly controlled in the majority of the patients (91%). At the time of the first attack, six of the patients had background diabetic retinopathy (BDR), three had pre-proliferative diabetic retinopathy (PPDR) and only two had proliferative diabetic retinopathy (PDR). The severity of diabetic retinopathy was mainly determined by the duration of diabetes (BDR, 11.9±6.7 years vs PPDR or PDR, 20.2±8.0 years, p=0.07). No correlation was found between the severity of diabetic retinopathy and the duration of diabetic ophthalmoplegia (BDR, 8.4±1.6 weeks; PPDR, 10.3±3.8 weeks; PDR, 10.0±5.6 weeks). Diabetic retinopathy did not progress during the attack of ophthalmoplegia in any of the patients.