Factors affecting outcome in ocular myasthenia gravis
- 1 January 2018
- journal article
- research article
- Published by Taylor & Francis Ltd in International Journal of Neuroscience
- Vol. 128 (1), 15-24
- https://doi.org/10.1080/00207454.2017.1344237
Abstract
Aim of the study: 50%-60% of patients with ocular myasthenia gravis (OMG) progress to generalized myasthenia gravis (GMG) within two years. The aim of our study was to explore factors affecting prognosis of OMG and to test the predictive role of several independent clinical variables.Materials and methods: We reviewed a cohort of 168 Caucasian patients followed from September 2000 to January 2016. Several independent variables were considered as prognostic factors: gender, age of onset, results on electrophysiological tests, presence and level of antibodies against acetylcholine receptors (AChR Abs), treatments, thymic abnormalities. The primary outcome was the progression to GMG and/or the presence of bulbar symptoms. Secondary outcomes were either achievement of sustained minimal manifestation status or worsening in ocular quantitative MG subscore (O-QMGS) or worsening in total QMG score (T-QMGS), assessed by Myasthenia Gravis Foundation of America (MGFA) quantitative scores. Changes in mental and physical subscores of health-related quality of life (HRQoL) were assessed with SF-36 questionnaire. Variance analysis was used to interpret the differences between AChR Ab titers at different times of follow up among the generalized and non-generalized patients.Results: Conversion to GMG occurred in 18.4% of patients; it was significantly associated with sex, later onset of disease and anti-AChR Ab positivity. Antibody titer above the mean value of 25.8 pmol/mL showed no significant effect on generalization. Sex and late onset of disease significantly affected T-QMGS worsening. None of the other independent variables significantly affected O-QMGS and HRQoL.Conclusions: Sex, later onset and anti-AChR Ab positivity were significantly associated with clinical worsening.This publication has 43 references indexed in Scilit:
- Ocular myasthenia gravisCurrent Opinion in Opthalmology, 2012
- Predictors of response to immunomodulation in patients with myasthenia gravisMuscle & Nerve, 2011
- Diagnostic utility of stimulated single‐fiber electromyography of the orbicularis oculi muscle in patients with suspected ocular myastheniaMuscle & Nerve, 2011
- The MG‐QOL15 for following the health‐related quality of life of patients with myasthenia gravisMuscle & Nerve, 2010
- Guidelines for treatment of autoimmune neuromuscular transmission disordersEuropean Journal of Neurology, 2010
- Ocular myasthenia gravis in a senior population: Diagnosis, therapy, and prognosisMuscle & Nerve, 2009
- Autoimmune myasthenia gravis: emerging clinical and biological heterogeneityThe Lancet Neurology, 2009
- Thymoma and Thymic Carcinoma: An Update of the WHO Classification 2004Surgery Today, 2005
- A Comparison of Electrodiagnostic Tests in Ocular Myasthenia GravisJournal of Clinical Neuromuscular Disease, 2005
- The MOS 36-ltem Short-Form Health Survey (SF-36)Medical Care, 1992