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Abstract
Methods
All patients presenting with diplopia from October 2010 to March 2012 and followed up for more than 3 months were retrospectively investigated.
Results
During the study period, 59 patients with diplopia were identified. There were 42 males and 17 females with an average age of 50 years. Binocular diplopia accounted for 54 cases (92%) and 5 cases (8%) had monocular diplopia. Cranial nerve palsies were the most common cause of binocular diplopia (28 cases, 52%). Within the cranial nerve palsies group, 14 cases (50%) were accompanied by hypertension or diabetes mellitus. Binocular diplopia spontaneously resolved in 35 cases (65%) by 3 months rising to 41 cases (76%) by 7 months. Thirteen (93%) out of 14 cases of cranial nerve palsies with hypertension or diabetes resolved spontaneously by 3 months.
Conclusions
Binocular diplopia was caused most commonly by cranial nerve palsy and resolved after 3 months in 65% of patients. A spontaneous recovery from diplopia was observed after 3 months in 93% of patients with cranial nerve palsies and microvascular disease such as hypertension or diabetes. Therefore, the initial observation without additional treatment would be sufficient in these patients.
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Figure 1.
The Kaplan-Meier survival curve for recovery of diplopia. The difference between two groups was statistically insignificant (p = 0.291, log rank test). Cumulative recovery rate in the microvascular group was 93% at 12 weeks; that in the non-microvascular group was 64% at 12 weeks and 79% at 20 weeks from the development of diplopia.
Table 1.
Characteristics of the patients
| Number of patients (%) | |
|---|---|
| Age (years) | |
| 10-30 | 14 (24) |
| 30-50 | 15 (25) |
| 50-70 | 19 (32) |
| 70-90 | 11 (19) |
| Sex | |
| Male | 42 (71) |
| Female | 17 (29) |
| Diplopia | |
| Monocular | 5 (8) |
| Binocular | 54 (92) |
| Total | 59 (100) |
Table 2.
Causes of monocular diplopia
| Cause | Number of patients |
|---|---|
| Astigmatism | 3 |
| Trauma | 1 |
| Migraine | 1 |
| Total | 5 |
Table 3.
Causes of binocular diplopia
Table 4.
Causes of cranial nerve palsies
Table 5.
Age-stratified causes of binocular diplopia
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