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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Neuro-Ophthalmology
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1470805

Clinical Predictors of Causative Radiographic Findings in Adults with Acute Onset Diplopia

Provisionally accepted
Yubin Son Yubin Son 1Hie Bum Suh Hie Bum Suh 2Hee-young Choi Hee-young Choi 1Michelle T. Cabrera Michelle T. Cabrera 3Hyeshin Jeon Hyeshin Jeon 1,2*
  • 1 Pusan National University, Busan, Busan, Republic of Korea
  • 2 Pusan National University Hospital, Seo-gu, Republic of Korea
  • 3 Seattle Children's Hospital, Seattle, Washington, United States

The final, formatted version of the article will be published soon.

    Objective: This study aimed to investigate the clinical factors that predict abnormal radiographic findings in adults with acute onset binocular diplopia. Methods: Medical records of consecutive patients aged > 20 years who presented with acute binocular diplopia were retrospectively reviewed. Patients were divided into positive and negative groups according to radiographic findings. Demographic and clinical characteristics were compared. The risk factors for positive radiographic findings were investigated, and the area under the receiver operating characteristic curve (AUC) was calculated. Results: Among 242 patients (145 males and 97 females), 44 (18.2%) were in the positive group and 198 (81.8 %) in the negative group. Patients in the positive group were older (p=0.005) and had more vasculopathic risk factors (p=0.038). Severe duction limitation (>50% reduction in motility) was present in 90.9% of patients in the positive group and 56.1% in the negative group (p<0.001). Abnormal slit lamp findings and pupillary exam abnormalities were also more frequent in the positive group than in the negative group (p=0.027 and p=0.036, respectively). Older age, higher intraocular pressure, abnormal slit-lamp findings, exophthalmos, and duction limitation were identified as risk factors for positive radiographic findings. A predictive model generated an AUC of 0.772. Conclusion: Older age and vasculopathic risk factors were associated with underlying radiographic pathologies, supporting the recommendation that neuroimaging should not be delayed in those patients. Careful ophthalmic evaluations may guide diagnosis and decision-making for immediate neuroimaging in cases of diplopia.

    Keywords: Strabismus, binocular, Diplopia, Cranial nerve palsy, diagnosis, MRI

    Received: 26 Jul 2024; Accepted: 30 Oct 2024.

    Copyright: © 2024 Son, Suh, Choi, Cabrera and Jeon. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hyeshin Jeon, Pusan National University Hospital, Seo-gu, Republic of Korea

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