Ophthalmologic Manifestations of Ocular Myasthenia Gravis
10.3341/jkos.2023.64.10.957
- Author:
Yong Hoon SEO
1
;
Won Jin YANG
;
Shin Yeop OH
Author Information
1. Department of Ophthalmology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
- Publication Type:Original Article
- From:Journal of the Korean Ophthalmological Society
2023;64(10):957-965
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Purpose:We investigated the ophthalmic manifestations observed in patients diagnosed with ocular myasthenia gravis.
Methods:In total, 58 patients diagnosed with ocular myasthenia gravis visited the ophthalmology and neurology departments between January 2011 and August 2022. Patients were followed for > 6 months; their ophthalmic manifestations were analyzed retrospectively.
Results:The study included 29 males and 29 females with a mean age of 55.52 ± 15.60 years. Among the patients, 31 tested positive for anti-acetylcholine receptor antibodies, resulting in a positive rate of 53.45%. Abnormalities in repeated nerve stimulation tests were observed in 33.33% of the patients. The antibody-positive group exhibited a higher frequency of progression to generalized myasthenia gravis (p = 0.011) and a higher incidence of chest abnormalities (p < 0.001) compared to the antibody-negative group. Horizontal and vertical diplopia were commonly observed in a complex group of patients with diplopia and blepharoptosis (p < 0.001); there was a difference in the pattern of strabismus between the diplopia single group with esotropia and the complex group with exotropia (p = 0.029). In addition, the combination group demonstrated a higher antibody titer (p = 0.034), a higher frequency of abnormalities in repeated nerve stimulation tests (p = 0.022), and a higher incidence of chest abnormalities (p = 0.022).
Conclusions:The anti-acetylcholine receptor antibody-positive group had a higher incidence of progression to generalized myasthenia gravis; moreover, the complex group of patients with diplopia and ptosis exhibited elevated levels of anti-acetylcholine receptor antibodies and frequently accompanied both horizontal and vertical strabismus.
