Diabetic changes of the extra-ocular muscles in man

Abstract

Axonal and myelin changes of the degenerative type were found in the extra-ocular muscles of 21 out of 23 diabetics of all ages (30--74 years). In all these 21 cases both axonal and myelin changes were observed; they did not correlate with the duration, degree of severity or treatment of diabetes. In 19 of the 23 cases (82.6%) nervous changes were accompanied by vascular changes. In 10 controls (50--80 years) nervous and vascular changes were of a slight degree. The findings of the alteration of peripheral nerve endings in the extra-ocular muscle corroborate and complete the description of the central nervous changes in diabetics with ophthalmoplegia given by several authors. We agree with Domínguez et al. that ophthalmoplegia may appear in the preclinical stage of diabetes and may be the first manifestation of the disease.

Glucose metabolism in the idiopathic blepharoptosis: Utility of the Oral Glucose Tolerance Test (OGTT) and of the Insulin Resistance Index

“…Besides the authors identified environmental toxic exposure and hypertriglyceridemia, but not glucose tolerance or IR as significant risk factors of chronic idiopathic polyneuropathy [16]. The relation between blepharoptosis and DM is well-known, conversely there are only some not controlled studies between blepharoptosis and manifestations of prediabetes [17,18]. Our data documented a strong linkage between blepharoptosis and glucose metabolism abnormality (IGT, DM, IR) in patients with normal fasting glycaemia.…”

Sexual Dysfunction in Women with Diabetes Mellitus

“…Table 2 summarizes the studies currently available through database searches. Three studies, for which we were unable to retrieve the original references, have not been included (Ellenberg, 1977;Montenero & Donatoni, 1973;Zrustova, Rostlapil, & Kabrhelova, 1978).…”

Retinopathy in Patients with Diabetic Ophthalmoplegia

“…Findings of some histopathological studies are consistent with this hypothesis. Zrustova et al [9], in a study of 23 diabetic patients, evaluated the changes in the extraocular muscles and their innervations and reported that diabetics had degenerative axonal changes and abnormal myelin sheath swelling compared with nondiabetic controls. These neural changes did not correlate with duration, degree of severity, treatment of the disease or the presence of diabetic retinopathy [9].…”

“…Zrustova et al [9], in a study of 23 diabetic patients, evaluated the changes in the extraocular muscles and their innervations and reported that diabetics had degenerative axonal changes and abnormal myelin sheath swelling compared with nondiabetic controls. These neural changes did not correlate with duration, degree of severity, treatment of the disease or the presence of diabetic retinopathy [9]. In a study evaluating the extraocular muscles and their innervations in diabetic patients with oculomotor nerve palsy, hyaline thickening of intraneural arterioles and localized nerve changes consistent with ischemia such as necrosis or interstitial edema have been demonstrated.…”