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ISSN 1561-3070 (Electronic)

2022, Number 1

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Rev Cub Oftal 2022; 35 (1)

Etiology and course of binocular diplopia in patients with oculomotor paresis or paralysis

Méndez STJ, Oest SLR, Hernández EO, Sibello DS, Pons CL

Language: Spanish
References: 33
Page: 1-18
PDF size: 271.03 Kb.


ABSTRACT

Objective: To determine the etiology and evolution of binocular diplopia in patients with oculomotor paresis or paralysis.
Methods: A descriptive, longitudinal and prospective study was carried out, from May 2018 to June 2019, of a series of cases that were assisted in the consultation of the Pediatric Ophthalmology Service at Ramón Pando Ferrer Cuban Institute of Ophthalmology and met the inclusion criteria. The variables evaluated were age, sex, risk factors, etiology, treatment options and elimination of diplopia.
Results: The mean age of the studied sample was 56.8 years and the male sex predominated (56.7% versus 43.3%). The most frequent risk factor was microvascular (86.7%), fourteen patients with arterial hypertension and 12 with diabetes mellitus. Microvascular etiology also predominated in 18 patients out of 30. The medical treatment only solved 66.7% of the studied sample and 86.7% of cases eliminated diplopia in all diagnostic gaze positions.
Conclusions: The most frequently affected cranial nerve is the sixth and microvascular etiology prevailed in the sixth and third cranial nerves, however, for the fourth traumatic is the only cause found, which is consistent with the literature reviewed.


REFERENCES

  1. Merino P, Fuentes D, Gómez de Liaño P, Ordóñez MA. Diplopía binocular en un hospital terciario: etiología, diagnóstico y tratamiento. Arch Soc Esp Oftalmol. 2017 ;92(12):565-70.

  2. Bidot S, Biousse V. Diplopie: un symptôme important en médecine interne?! Rev Médecine Interne. 2017;38(12):806*16.

  3. McCormack GL, Hogan KM. Clear and Single Binocular Vision in Near 3D Displays: Optom Vis Sci. 2019 Nov;96(11):850-9.

  4. Prieto J, Souza C. Estrabismo. 5th ed. Buenos Aires: Ediciones científicas argentinas; 2005.

  5. Duane T, Tasman W, Jaeger EA. Duane's ophthalmology. Rev. ed. 2013.

  6. Choi KD, Choi SY, Kim JS, Choi JH, Yang TH, Oh SY, et al. Acquired Ocular Motor Nerve Palsy in Neurology Clinics: A Prospective Multicenter Study. J Clin Neurol. 2019;15(2):221.

  7. de Meel RHP, Raadsheer WF, van Zwet EW, Tannemaat MR, Verschuuren JJGM. Ocular Weakness in Myasthenia Gravis: Changes in Affected Muscles are a Distinct Clinical Feature. J Neuromuscul Dis. 2019;6(3):369-76.

  8. Mamalis C, Margolin E. Diplopia. In: Stat Pearls [Internet]. Treasure Island (FL): Stat Pearls Publishing; 2020 [cited 10 Jul 2020 ]. Available from: Available from: http://www.ncbi.nlm.nih.gov/books/NBK441905/

  9. Lutwak N. Binocular Double Vision - A Review. 2011; 4.

  10. Kumar S. Acute onset binocular diplopia: a retrospective observational study of 100 consecutive cases managed at a tertiary eye centre in Saudi Arabia. Eye Lond Engl. 2020 Sep;34(9):1608-1613. doi: 10.1038/s41433-019-0705-7

  11. Pineles SL, Velez FG. Isolated Ocular Motor Nerve Palsies. J Binocul Vis Ocul Motil. 2018 Jul 3;68(3):70-7.

  12. Pelak VS. Evaluation of Diplopia: An Anatomic and Systematic Approach. Hosp Physician. 2004 Jan;40(3):16-25.

  13. Peragallo J, Newman N. Diplopia-An Update. Semin Neurol. 2016 Sep 19;36(04):357-61.

  14. Kirsch CFE, Black K. Diplopia: What to Double Check in Radiographic Imaging of Double Vision. Radiol Clin North Am. 2017;55(1):69-81.

  15. Hatt SR, Leske DA, Holmes JM. Comparing Methods of Quantifying Diplopia. Ophthalmology. 2007;114(12):2316-22.

  16. Campos EC. Why do the eyes cross? A review and discussion of the nature and origin of essential infantile esotropia, microstrabismus, accommodative esotropia, and acute comitant esotropia. J Am Assoc Pediatr Ophthalmol Strabismus. 2008 ;12(4):326-31.

  17. Yoo HS, Park E, Rhiu S, Chang H-J, Kim K, Yoo J, et al. A computerized red glass test for quantifying diplopia. BMC Ophthalmol. 2017;17(1):71.

  18. Holmes JM, Liebermann L, Hatt SR, Smith SJ, Leske DA. Quantifying Diplopia with a Questionnaire. Ophthalmology. 2013;120(7):1492-6.

  19. Park K-A, Oh SY. Treatment for diplopia in patients with myasthenia gravis. Graefes Arch Clin Exp Ophthalmol. 2013;251(3):895-901.

  20. Al-Haidar M, Benatar M, Kaminski HJ. Ocular Myasthenia. Neurol Clin. 2018;36(2):241-51.

  21. Andalib D, Nabie R, Poormohammad B. Factors Affecting Improvement of Stereopsis Following Successful Surgical Correction of Childhood Strabismus in Adults. Strabismus. 2015;23(2):80-4.

  22. Ji N, Xu M, Yu H, Xu J, Yu X. Factors influencing the self-reported sense of deviation in adults with successful surgical outcomes for strabismus. BMC Ophthalmol. 2020;20(1):9.

  23. Dickmann A, Aliberti S, Rebecchi MT, Aprile I, Salerni A, Petroni S, et al. Improved sensory status and quality-of-life measures in adult patients after strabismus surgery. J Am Assoc Pediatr Ophthalmol Strabismus. 2013;17(1):25-8.

  24. Rio M, Fernández L, Hernández JR. Oftalmología. Diagnóstico y tratamiento. 2da ed. La Habana: Editorial Ciencias Médicas; 2017.

  25. Kawai M, Goseki T, Ishikawa H, Hoshina M, Shoji N. Causes, background, and characteristics of binocular diplopia in the elderly. Jpn J Ophthalmol. 2018;62(6):659-66.

  26. Park K-A, Oh SY, Min J-H, Kim BJ, Kim Y. Cause of acquired onset of diplopia due to isolated third, fourth, and sixth cranial nerve palsies in patients aged 20 to 50 years in Korea: A high resolution magnetic resonance imaging study. J Neurol Sci. 2019;407:116546.

  27. Cioplean D, Nitescu Raluca L. Age related strabismus. Romanian J Ophthalmol. 2016; 60(2):54-8.

  28. Suh SY, Le A, Clark RA, Demer JL. Rectus Pulley Displacements without Abnormal Oblique Contractility Explain Strabismus in Superior Oblique Palsy. Ophthalmology. 2016;123(6):1222-31.

  29. Sharma P, Gaur N, Phuljhele S, Saxena R. What's new for us in strabismus? Indian J Ophthalmol. 2017;65(3):184-90.

  30. Chen CY. Using Botulinum Toxin A as an Adjunct in the Surgery of Large-Angle Sensory Exotropia and Abducens Nerve Palsy. Semin Ophthalmol. 2019;34(78):541-2.

  31. Escuder AG, Hunter DG. The Role of Botulinum Toxin in the Treatment of Strabismus. Semin Ophthalmol. 2019;34(4):198-204.

  32. Lambert SR, Lyons CJ. Taylor and Hoyt's Pediatric Ophthalmology and Strabismus. 5th ed. Philadelphia: Elsiever Saunders; 2016.

  33. Bartiss MJ. Nonsurgical treatment of diplopia. Curr Opin Ophthalmol. 2018;29(5):381-4.




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