Radiological findings in patients with isolated acute-onset ocular motility disorders
Bibliographic record
Abstract
To image or not to image is a critical question in patients with isolated acute-onset ocular motility disorders (AOMD), without any neurological symptoms/signs. Imaging may help in diagnosis; but is associated with risks and costs. The study aimed to evaluate radiological findings in patients with apparently isolated AOMD on clinical exam, and identify patient/disease characteristics more likely to be associated with positive imaging. A retrospective review of patient charts with isolated AOMD (< 3 months onset), who were examined by an ophthalmologist and had imaging at a tertiary-care center over a period of 18 months, was conducted. Ophthalmology exam and diagnostic imaging findings were recorded. Radiological findings were classified as “clinically relevant”, “non-relevant”, and “normal/no positive” findings. 46 patients were included (3-91 years; 27 males, 19 females). 19 were clinically classified as nerve palsy (1 third, 10 fourth, and 8 sixth nerve), 14 acute-onset esotropia, 3 acute-onset exotropia, 7 acute-onset vertical strabismus inconsistent with nerve palsy, and 3 limitation of elevation/suspected dorsal midbrain syndrome. We found 8/46 (17%) with clinically relevant imaging findings; of these, 5/46 (11%) had positive neuro-imaging findings (mass, malformation, aneurysm, infarct) and 3/46 (7%) had positive orbital imaging findings (thyroid eye disease). Positive neuro-imaging was more common in patients with certain symptoms (headache), in certain clinical diagnostic entities (dorsal midbrain syndrome spectrum, acute-onset esotropia), and in younger patients (<40 years). Positive neuro-imaging findings may be seen even in patients with apparently isolated ocular symptoms/signs on clinical exam. This data may help institutions with decision-making and policy formulation for imaging patients with isolated AOMD.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".