Summary
Myasthenia gravis (MG) is an autoimmune disease affecting the neuromuscular junction, it is characterized by exertional weakness and fatigability.[1] This disease generally begins with ocular symptoms (ptosis and/or diplopia) in up to 85% of patients and extends to other muscles (generalized MG, GMG).
Original Article
Diagnostic yields and clinical features of ocular myasthenia gravis
Medicine
Kim, Hyuna MDa; Oh, Shin Yeop MDb
Abstract
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.
Author contributions
Conceptualization: Hyuna Kim, Shin Yeop Oh.
Data curation: Hyuna Kim, Shin Yeop Oh.
Formal analysis: Hyuna Kim, Shin Yeop Oh.
Methodology: Shin Yeop Oh.
Resources: Hyuna Kim, Shin Yeop Oh.
Supervision: Shin Yeop Oh.
Validation: Hyuna Kim.
Visualization: Hyuna Kim.
Writing – original draft: Hyuna Kim.
Writing – review & editing: Shin Yeop Oh.
