Risk factors for ischemic ocular motor nerve palsies
D. M. Jacobson, T. D. McCanna and P. M. Layde
Department of Neurology, Marshfield Clinic, Wis.
OBJECTIVE: To identify risk factors associated with neurologically isolated
ischemic ocular motor nerve palsies. DESIGN: Case-control study. SETTING:
Multispecialty clinic providing primary, secondary, and tertiary care in
central and northern Wisconsin. STUDY PARTICIPANTS: After applying strict,
predetermined, inclusion and exclusion criteria to the medical records of
patients with ocular motor nerve palsies, 65 case patients 50 years of age
or older were identified with ischemic ophthalmoplegia. A control subject,
matched for sex and exact year of age, was randomly selected for each case
patient from individuals undergoing a comprehensive medical evaluation.
MAIN OUTCOME MEASURES: Prevalence of potential risk factors in case
patients and controls, including diabetes, hypertension,
hypercholesterolemia, coronary artery disease, left ventricular
hypertrophy, adiposity, tobacco use, prior ocular motor nerve palsy, and
hematocrit. Risk factors were assessed using standardized definitions.
RESULTS: After adjustment for potential confounding factors, significant
risk factors and their associated odds ratios (ORs) and 95% confidence
intervals (CIs) were as follows: previously diagnosed diabetes, OR = 5.75
(CI = 1.68 to 19.7); left ventricular hypertrophy, OR = 5.20 (CI = 1.30 to
20.82); and, hematocrit (per percentage increase), OR = 1.35 (CI = 1.13 to
1.61). CONCLUSION: In addition to the generally accepted risk factor of
diabetes, left ventricular hypertrophy and elevated hematocrit appeared to
be important determinants of ischemic ocular motor nerve palsy. Additional
studies should be undertaken to confirm these findings.
