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Clinical Manifestations in Diabetics with Retinopathy and Ophthalmoplegia

外眼神經麻痺併糖尿病網膜症病患之臨床表現

摘要


追蹤研究11位病人罹患糖尿病外眼神經麻痺併糖尿病網膜症之病眼。其中6例屬第三對腦神經麻痺,另外5例屬第六對腦神經麻痺。有二位病人(18%)分別在4年及6年後有復發性腦神經麻痺。所有腦神經麻痺皆完全復原。大部分病人(91%)血糖控制不住。糖尿病網膜症方面,於出次發作時,6例屬背景性非增殖性糖尿病網膜症(BDR),3例屬預增殖性糖尿病網膜症(PPDR),僅2例屬增殖性糖尿病網膜症(PDR)。糖尿病網膜症之嚴重程度與罹患糖尿病之時間長短成正比(BDR,11.9±6.7年vs PPDR or PDR, 20.2±8.0年,p=0.07)。糖尿病外眼神經麻痺復原時間之長短與糖尿病網膜症之嚴重程度並無關連(BDR: 8.4±1.6週;PPDR: 10.3±3.8週;PDR:10.0±5.6週),且於糖尿病外眼神經麻痺復原期間,糖尿病網膜症並無進展現象。

並列摘要


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.

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