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Diplopia: characteristics and etiologic distribution in a referral-based university hospital

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Abstract

Background and objectives

The etiologic distribution and clinical features of diplopia may differ according to the specialties involved in the management. This study aimed to establish the clinical features and underlying etiologies of diplopia by recruiting patients from all departments.

Methods

We reviewed the medical records of 4127 patients with diplopia as the chief complaint, who had been recruited from all departments at Seoul National University Bundang Hospital, Seongnam, Republic of Korea, from 2003 to 2020.

Results

Diplopia was binocular in 3557 (94.2%) and monocular in 219 (5.8%) patients. The common causes of binocular diplopia included microvascular (n = 516, 14.5%), strokes (n = 412, 11.6%), neoplastic (n = 304, 8.5%), myasthenia gravis (n = 253, 7.1%), traumatic (n = 240, 6.7%), and decompensated phoria (n = 232, 6.5%), and comprised more than a half of the causes. Patients with binocular diplopia were usually managed by neurologists (2549/3557, 71.7%), followed by ophthalmologists (2247/3557, 63.2%), emergency physicians (1528/3557, 43.0%), neurosurgeons (361/3557, 10.1%), and others (271/3557, 7.6%). The etiologies of binocular diplopia differed markedly according to the patients’ age and the specialties involved in the management (p < 0.001).

Conclusions

Given the differences in the etiologic distribution of diplopia according to the patients’ age and the specialties involved in the management, the results of previous reports on the characteristics and etiology of diplopia, primarily performed in a single specialty department, should be interpreted with a possible selection bias.

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Data availability statement

Anonymized data will be shared by request from any qualified investigator.

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Funding

This study was supported by the National Research Foundation of Korea (NRF) grant funded by the Ministry of Science and ICT (No. NRF-2021R1F1A1061527).

Author information

Authors and Affiliations

  1. Department of Neurology, Chungbuk National University Hospital, Cheongju, Republic of Korea

    Hyun-Jae Kim

  2. Department of Medical Sciences, Neurology, Graduate School of Ajou University, Suwon, Republic of Korea

    Hyun-Jae Kim

  3. Research Administration Team, Seoul National University Bundang Hospital, Seongnam, Republic of Korea

    Hyo-Jung Kim

  4. Department of Neurology, Clinical Neuroscience Center, Dizziness Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea

    Jeong-Yoon Choi & Ji-Soo Kim

  5. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea

    Hee Kyung Yang & Jeong-Min Hwang

  6. Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea

    Jeong-Yoon Choi & Ji-Soo Kim

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  1. Hyun-Jae Kim
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Contributions

HJK analyzed and interpreted the data and wrote the manuscript. HJK, JYC, HKY, JMH, HJK, and JSK analyzed and interpreted the data and revised the manuscript. JSK designed and conceptualized the study, interpreted the data, and revised the manuscript.

Corresponding author

Correspondence to Ji-Soo Kim.

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Conflicts of interest

Dr. J. S. Kim serves as an associate editor of Frontiers in Neuro-otology and on the editorial boards of the Journal of Clinical Neurology, Frontiers in Neuro-ophthalmology, Journal of Neuro-ophthalmology, Journal of Vestibular Research, Journal of Neurology, and Medicine. The other authors have nothing to disclose.

Ethical standard

This study followed the tenets of the Declaration of Helsinki and was performed according to the guidelines of the Institutional Review Board of Seoul National University Bundang Hospital (B-2109–707-001).

Supplementary Information

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Kim, HJ., Kim, HJ., Choi, JY. et al. Diplopia: characteristics and etiologic distribution in a referral-based university hospital. J Neurol 270, 1067–1075 (2023). https://doi.org/10.1007/s00415-022-11471-7

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  • DOI: https://doi.org/10.1007/s00415-022-11471-7

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