4.5 Article

Diagnostic yields and clinical features of ocular myasthenia gravis

Journal

MEDICINE
Volume 100, Issue 25, Pages -

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MD.0000000000026457

Keywords

diplopia; myasthenia gravis severity; ocular myasthenia gravis; ptosis; pyridostigmine

Funding

  1. National Research Foundation of Korea [NRF2020R1F1A1072382]

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This study investigated the clinical features and diagnosis process of ocular myasthenia gravis (OMG) in an ophthalmology department. Patients were divided into two groups based on serologic test results for comparison. The study found that patients with two clinical symptoms had significantly higher AchR Ab titers than those with only one clinical symptom.
To investigate clinical features and diagnosis process of ocular myasthenia gravis (OMG) in ophthalmology department. A total of 36 patients with ptosis or diplopia who had follow-up for at least 3 months between March 2016 and December 2019 were included in this study. Clinical symptoms of patients and the test results were analyzed. According to the positivity of serologic test, these patients were divided into 2 groups (confirmed OMG and possible OMG with relief of symptoms after antimyasthenic treatment) for comparison. Ptosis was present in 12 (33.33%) patients, diplopia was present in 14 (38.89%) patients, and both ptosis and diplopia were present in 10 (27.78%) patients. Acetylcholine receptor auto-antibody (AchR Ab) was positive in 14 (38.89%) of 36 patients and ice test was positive in 15 (71.43%) of 21 patients with ptosis. Unequivocal response to pyridostigmine was observed in 31 (86.11%) patients. For seropositive cases, AchR Ab titer was significantly higher in the group with 2 clinical symptoms than that in the 1 clinical symptom (P = .011). This study presents the usefulness and diagnostic validity of antimyasthenic treatment for OMG, especially seronegative OMG, with detailed symptom analysis.

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