大阪医科大学附属病院眼科における糖尿病性眼筋麻痺の検討

Cases of diabetic ophthalmoplegia at Osaka Medical College Hospital

要約　目的：大阪医科大学附属病院眼科における糖尿病眼筋麻痺を検討した。

対象と方法：2005〜2009年に受診した後天性眼運動神経麻痺224例のうち，糖尿病性眼筋麻痺の占める割合，性別・年齢，治癒までの期間，疼痛の頻度，複合神経麻痺の有無について検討した。

結果：224例中糖尿病性眼筋麻痺は46例であり，男性30例，女性16例，治癒までの期間は平均14.5週で，疼痛を訴えたのは10例，複合神経麻痺は1例であった。

結論：糖尿病性眼筋麻痺は後天性眼運動神経麻痺の約20％を占め，疼痛を訴える症例もある。眼球運動障害を契機に糖尿病が見つかる場合もあり，眼運動神経麻痺の症例では糖尿病の検索を積極的に行うべきである。

Abstract　Purpose：To present a review of cases seen at Osaka Medical College Hospital during a 5-year period.

Cases and Method：This retrospective study was made on consecutive 224 cases who were diagnosed with acquired ophthalmoplegia by us from 2005 through 2009. Diabetes mellitus was the major causative factor in 46 cases（20.5％）. They were evaluated regarding age, sex, duration of ophthalmoplegia, pain, and associated neuropathies.

Results：The series comprised 30 males and 16 females. The age ranged from 45 to 83 years, average 68 years. Oculomotor nerve palsy was affected in 7 cases. These 7 cases were all males. Trochlear nerve palsy was affected in 8 cases. Abducens nerve palsy was affected in 31 cases. Spontaneous cure of ophthalmoplegia set in in all 37 cases who could be followed up long enough. Ten out of 46 cases complained of pain associated with ophthalmoplegia. One case showed bilateral abducens palsy and right oculomotor palsy.

Conclusion：Diabetic mellitus was the major cause in about 20％ of cases of acquired ophthalmoplegia. The present study illustrates that cases of acquired ophthalmoplegia ought to be examined regarding diabetes mellitus as the underlying disease.