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Ischemic Stroke Incidence in Patients With Microvascular Ocular Motor Palsy Versus Patients With Lacunar Ischemic Stroke

Beato-Coelho, José, MD*; Varela, Ricardo, MD*; Almendra, Luciano, MD*; Carvalho, Mário, MS; Duque, Cristina, MD*; Patrício, Miguel, PhD†,‡; Sargento-Freitas, João, MD*,†; Freire, António, MD, PhD*,†; Lemos, João, MD, PhD*,†

doi: 10.1097/NRL.0000000000000213
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Objective: Presumed microvascular ischemia is the most frequent cause of ocular motor palsy (OMP). Ischemic stroke incidence after an episode of microvascular OMP (mOMP) is not established, contrasting with other common vascular conditions, such as lacunar ischemic stroke (LS). We sought to compare the incidence of subsequent ischemic stroke between mOMP and LS populations.

Methods: A retrospective observational analysis was conducted on acute patients presenting with either mOMP or LS. A propensity score match was applied to ensure a balance between groups. We compared the incidence of subsequent ischemic stroke during an 80-month follow-up.

Results: A total of 110 patients were included in the study (57, mOMPs; 53, LS). During follow-up, the annual occurrence rate of ischemic stroke was 2.1% per year in mOMP group and 0.6% per year in the LS group. After performing Cox regression, we found no statistical significance difference between groups in the incidence of subsequent ischemic stroke (P=0.801).

Conclusions: Patients with presumed mOCP seem to share similar incidence of subsequent ischemic stroke with patients with LS. Presumed mOCP may be an underrecognized independent risk factor for ischemic stroke.

*Neurology Department, Coimbra University Hospital Centre

Faculty of Medicine

Laboratory of Biostatistics and Medical Informatics, Coimbra University, Coimbra, Portugal

J.B.-C. and R.V. are co-first authors and contributed equally to this manuscript.

J.B.-C. and R.V.: contributed to acquisition, analysis and interpretation of the data, and drafting of the manuscript. L.A., M.C., and M.P.: contributed to acquisition, analysis and interpretation of the data. J.S.-F. and A.F.: contributed to acquisition, analysis and interpretation of the data, concept and design, and critical revision of manuscript for intellectual content. J.L.: contributed to acquisition, analysis and interpretation of the data, drafting of the manuscript, study supervision, concept and design, and critical revision of the manuscript for intellectual content.

The authors declare no conflict of interest.

Correspondence to: João Lemos, MD, PhD, Department of Neurology, Coimbra University Hospital Centre, Praceta Professor Mota Pinto, Coimbra 3000-075, Portugal. E-mail: merrin72@hotmail.com.

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