Xue Zhaowen, Cao Tianxiang, Li Xuemei, Hu Deyu, Li Yuan, Zhou Lingyun
Ocular Motility Disorder Treatment Centre, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, China.
Department of Acupuncture and Moxibustion, The Second Affiliated Hospital of Heilongjiang, University of Chinese Medicine, Heilongjiang, China.
BMC Ophthalmol. 2025 Jul 14;25(1):407. doi: 10.1186/s12886-025-04237-y.
Few literatures reported the clinical characteristics of diabetic trochlear nerve palsy, including demographic characteristics, involvement between both eyes, time of symptom onset, duration of diabetes, etc. Whether there is relevance between these data and the severity of diplopia deserves to be analyzed.
To clarify the clinical characteristics of diabetic trochlear nerve palsy patients and their correlation with the severity of diplopia.
DESIGN, SETTING, AND PARTICIPANTS: Medical records of 609 isolated trochlear nerve palsy patients admitted to the Ocular Motility Disorder Treatment Centre of the First Affiliated Hospital of Harbin Medical University between December 2018 and October 2024 were reviewed and 92 eligible cases were enrolled in this study.
To evaluate the orientation and severity of diplopia, all patients were examined with neuroimaging, completed the computerized diplopia test and were assessed with the Ocular Motor Nerve Palsy Scale.
Among the 92 patients aged 44 to 86 years (62.10 ± 8.04 years), the majority of the patients were male (n = 67, 73%)with no bilateral trochlear nerve palsy reported in all patients. The duration of diabetes ranged from 0.5 to 30 years (11.37 ± 8.02 years), and the time of symptom onset for all patients ranged from 2 to 111 days (14.68 ± 15.64 days). The average level of hemoglobin A1c (HbA1c) was 8.02 ± 1.48(%) and the average maximum vertical deviation was 5.38°±2.18°. A significant correlation was found between the duration of diabetes and the severity of diplopia (P = 0.026) but other indicators were not. The duration of diabetes was an independent risk factor for the severity of diplopia (P = 0.035, OR = 1.004, 95% CI, 1.001-1.008).
This retrospective study suggests that the duration of diabetes plays an important role in diabetic trochlear nerve palsy and a longer duration of diabetes could lead to more severe diplopia in patients. Findings of this study may provide help for clinical treatment and prognosis.
很少有文献报道糖尿病性滑车神经麻痹的临床特征，包括人口统计学特征、双眼受累情况、症状发作时间、糖尿病病程等。这些数据与复视严重程度之间是否存在相关性值得分析。
阐明糖尿病性滑车神经麻痹患者的临床特征及其与复视严重程度的相关性。
设计、设置和参与者：回顾了2018年12月至2024年10月期间哈尔滨医科大学附属第一医院眼动障碍治疗中心收治的609例孤立性滑车神经麻痹患者的病历，本研究纳入了92例符合条件的病例。
为评估复视的方向和严重程度，所有患者均接受了神经影像学检查，完成了电脑化复视测试，并采用眼动神经麻痹量表进行评估。
92例患者年龄在44至86岁之间（平均年龄62.10±8.04岁），大多数患者为男性（n = 67，73%），所有患者均未报告双侧滑车神经麻痹。糖尿病病程为0.5至30年（平均11.37±8.02年），所有患者症状发作时间为2至111天（平均14.68±15.64天）。糖化血红蛋白（HbA1c）平均水平为8.02±1.48（%），平均最大垂直偏差为5.38°±2.18°。发现糖尿病病程与复视严重程度之间存在显著相关性（P = 0.026），但其他指标无相关性。糖尿病病程是复视严重程度的独立危险因素（P = 0.035，OR = 1.004，95%CI，1.001 - 1.008）。
这项回顾性研究表明，糖尿病病程在糖尿病性滑车神经麻痹中起重要作用，糖尿病病程较长可能导致患者复视更严重。本研究结果可能为临床治疗和预后提供帮助。
