Objective To evaluate the clinical characteristics,treatment and outcome of patients diagnosed with ocular myasthenia gravis. Methods Cases review study. Outpatients with ocular myasthenia gravis (OMG) presented to neuro-ophthalmology division between May 2022 and May 2023 were collected. The demographic data along with ophthalmologic examinations,were evaluated. Results A total of 40 patients (27 males and 13 females) with a mean age of (50.45±18.03) years (range:4-89) were included in the study. The mean course between presenting and final diagnosis was (6.72±17.35) months (range:0.25-72). The mean follow-up was (14.00±2.63) months (range:12-20). Monocular involvement occurred in 25 cases and binocular in 15 cases. Isolated ptosis was found in 8 cases (20.00％),isolated extraocular muscle paralysis in 5 cases (12.50％) and 27 cases (67.50％) had both manifestations. The positive rates for the fatigue test,ice test and AChR antibody testing were 88.46％,82.35％ and 46.15％ respectively. Thyroid dysfunction was found in 14 patients (73.68％,14/19). Chest CT scans revealed thymoma in 2 cases who subsequently underwent thymectomy and thymic hyperplasia in 3 cases. Thirty-nine patients accepted medical treatment,including 1 case with pyridostigmine bromide,14 cases with prednisone,12 cases with pyridostigmine bromide combined with prednisone and 12 cases with prednisone combined with non-steroidal immunosuppressants. The mean medication time was (13.00±7.63) months (range:1-20). After an average treatment period of (4.14±3.66) months (range:0.25-12),27 patients (67.50％) acquired remission or minimal manifestation status and 13 patients (32.50％) showed improvement. There was no case progressing to generalized MG. Twenty-nine cases (72.50％) had only one episode and 11 cases (27.50％) relapsed once or more during the period of follow-up. Conclusions OMG is a common cause leading to ptosis and diplopia. The fatigue test and ice test show higher positive rates compared to serum antibody tests and therefore have important diagnosis value for OMG. The immunosuppressive therapy,to a certain extent,reduces both recurrence risk and progression to generalized MG.
维普
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