Ophthalmologic manifestations in myasthenia gravis: presentation and prognosis
Küçük Resim Yok
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Springer Science and Business Media Deutschland GmbH
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
We investigated the ophthalmologic manifestations and factors that influence outcomes in patients with myasthenia gravis (MG). We retrospectively analyzed the prevalence of neuro-ophthalmologic findings and clinical and outcome measures of 100 consecutive patients (53 males, 47 females), aged 55.7 ± 17.5 (range 15–85) years with an established diagnosis of MG. Forty-eight patients had purely ocular symptoms at the onset of disease (OMG) and 52 patients presented with generalized symptoms (GMG). Overall, 21 patients presented with extraocular muscle (EOM) weakness. Bilateral EOM weakness was seen in 12 patients, and unilateral EOM weakness was seen in nine patients. Diplopia responded partially to immunosuppressive treatments in 60% of patients with ophthalmoparesis. Twenty-five (52.1%) patients with ocular-onset MG converted to secondary GMG at a mean time of 14.5 months. Patients who developed secondary GMG were younger and had an earlier age of disease onset when compared with patients with pure OMG (p < 0.05). Patients with secondary GMG presented more frequently with ptosis and diplopia (72% vs. 28%) compared with patients with pure ocular MG who presented more frequently with isolated ptosis (66.7% vs. 33.3%) (p = 0.02). Remission and minimal manifestation status were achieved in 50 (79.3%) of all patients with a clinical follow-up ? 3 years. Poor outcome was associated with the presence of thymoma (p < 0.05). Myasthenic ophthalmoparesis is bilateral and heterogeneous and partly responds to treatment with immunotherapy. Younger patients with ptosis and diplopia at disease onset had an increased risk of secondary GMG. The presence of thymoma increases the risk for poor prognosis. © 2021, Belgian Neurological Society.
Açıklama
Anahtar Kelimeler
Diplopia; External Ocular Muscle Weakness; Neuromuscular Junction Disorders; Ocular Myasthenia Gravis; Ophthalmoparesis; Ptosis, Azathioprine; Cholinergic Receptor Antibody; Immunoglobulin; Prednisolone; Pyridostigmine; Rituximab; Immunosuppressive Agent; Abduction; Add On Therapy; Adolescent; Adult; Aged; Allergic Asthma; Antibody Titer; Article; Child; Clinical Outcome; Computer Assisted Tomography; Controlled Study; Diplopia; Disease Classification; Disease Duration; Drug Dose Reduction; Electromyography; Electrophysiology; Extraocular Muscle; Eye Disease; Female; Follow Up; Histopathology; Immunosuppressive Treatment; Immunotherapy; Major Clinical Study; Male; Muscle Weakness; Myasthenia Gravis; Nerve Paralysis; Nerve Stimulation; Ophthalmoplegia; Orbicularis Oculi Muscle; Outcome Assessment; Paresis; Plasma Exchange; Practice Guideline; Prevalence; Prognosis; Ptosis (Eyelid); Remission; Retrospective Study; Rheumatic Polymyalgia; Sjoegren Syndrome; Systemic Lupus Erythematosus; Thymectomy; Thymoma; Thyroid Disease; Complication; Diplopia; Eye Movement Disorder; Human; Middle Aged; Myasthenia Gravis; Ptosis (Eyelid); Treatment Outcome; Very Elderly; Young Adult; Adolescent; Adult; Aged; Aged, 80 And Over; Blepharoptosis; Diplopia; Female; Humans; Immunosuppressive Agents; Male; Middle Aged; Myasthenia Gravis; Ocular Motility Disorders; Treatment Outcome; Young Adult
Kaynak
Acta Neurologica Belgica
WoS Q Değeri
Scopus Q Değeri
Q2
Cilt
121
Sayı
5
