Korean J Ophthalmol.  2011 Feb;25(1):1-7. 10.3341/kjo.2011.25.1.1.

Comparison of Clinical Manifestations between Patients with Ocular Myasthenia Gravis and Generalized Myasthenia Gravis

• Roh HS
• Lee SY
• Yoon JS

• KMID: 994404
• DOI: http://doi.org/10.3341/kjo.2011.25.1.1

Abstract

PURPOSE
To compare the clinical manifestations between patients with ocular myasthenia gravis and those with generalized myasthenia gravis (MG).
METHODS
The medical records of 71 patients diagnosed with MG between January 1995 and December 2007 were reviewed. Demographics, sensitivities of diagnostic methods, the presence of systemic autoimmune diseases, ophthalmic complications caused by MG, and treatments were evaluated and compared.
RESULTS
Fourteen patients (20%) were diagnosed with ocular MG and 57 patients (80%) with generalized MG. Sensitivities of anti-acetylcholine receptor antibody and repetitive nerve stimulation tests were significantly higher in the generalized MG group (84%, 89%) compared to those in the ocular MG group (50%, 54%) (p = 0.011, p = 0.008). The sensitivity of the neostigmine test was the highest in both groups (98% of generalized MG, 79% of ocular MG), and the difference between the two groups was borderline significant (p = 0.058). The most common symptoms were ptosis and diplopia, and both groups presented with pain, blurred vision, and tearing. Systemic autoimmune disease was more prominent in the generalized MG group (21%) than in the ocular MG group (14%), and steroid therapy was used more frequently in the generalized MG group (82%) than in the ocular MG group (57%). Ophthalmic complications associated with long-term steroid treatment were more profound in the generalized MG (30%) compared to those of the ocular MG (21%).
CONCLUSIONS
The generalized MG group was associated with higher sensitivities to diagnostic tests, more systemic steroid use, higher ophthalmic complications caused by systemic autoimmune disease, and long-term steroid treatment compared to those of the ocular MG group.

Keyword

Clinical features; Myasthenia gravis; Ophthalmic complications; Sensitivity and specificity; Systemic autoimmune disease

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Autoimmune Diseases/complications
Child
Drug Administration Schedule
Eye Diseases/chemically induced/immunology
Female
Humans
Male
Middle Aged
Myasthenia Gravis/complications/*diagnosis/*drug therapy
Steroids/*administration & dosage/adverse effects
Young Adult

Figure

• 

  Fig. 1 Age of onset according to gender.

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