RISK-FACTORS FOR ISCHEMIC OCULAR MOTOR-NERVE PALSIES

Objective: To identify risk factors associated with neurologically iso lated ischemic ocular motor nerve palsies. Design: Case-control study. Setting: Multispecialty clinic providing primary, secondary, and tert iary care in central and northern Wisconsin. Study Participants: After applying strict, predetermined, inclusion and exclusion criteria to t he medical records of patients with ocular motor nerve palsies, 65 cas e patients 50 years of age or older were identified with ischemic opht halmoplegia. A control subject, matched for sex and exact year of age, was randomly selected for each case patient from individuals undergoi ng a comprehensive medical evaluation. Main Outcome Measures: Prevalen ce of potential risk factors in case patients and controls, including diabetes, hypertension, hypercholesterolemia, coronary artery disease, left ventricular hypertrophy, adiposity, tobacco use, prior ocular mo tor nerve palsy, and hematocrit. Risk factors were assessed using stan dardized definitions. Results: After adjustment for potential confound ing factors, significant risk factors and their associated odds ratios (ORs) and 95% confidence intervals (CTs) were as follows: previously diagnosed diabetes, OR=5.75 (CI=1.68 to 19.7); left ventricular hypert rophy, OR=5.20 (CI=1.30 to 20.82); and, hematocrit (per percentage inc rease), OR=1.35 (CI=1.13 to 1.61). Conclusion: In addition to the gene rally accepted risk factor of diabetes, left ventricular hypertrophy a nd elevated hematocrit appeared to be important determinants of ischem ic ocular motor nerve palsy. Additional studies should be undertaken t o confirm these findings.