Development of Generalized Myasthenia Gravis in Patients With Ocular Myasthenia Gravis

Prognosis of ocular myasthenia in Korea: A retrospective multicenter analysis of 202 patients

“…First of all, the prevalence of OMG was very similar to those reported in earlier studies with approximately 50% of our patients presenting with solely ocular disturbances [3,4]. In addition, the current study adds to the increasing body of evidence that shows a beneficial effect of early corticosteroid treatment on the risk of secondary generalization [4][5][6][7][8].…”

“…Previous studies have reported that ocular disturbances are the first and sole manifestation of MG in about 50% of patients and that between 50% and 60% of patients presenting with OMG subsequently progress to develop generalized disease, usually within the first 1 to 2 years [2,3]. Early immunosuppressive therapy, specifically corticosteroids and/or azathioprine, has been suggested to prevent or delay the secondary generalization [4][5][6][7][8], but the cost-to-benefit ratio of this treatment remains controversial with no randomized controlled study conducted thus far [9]. Only a few studies have addressed the prognostic factors for OMG [2,4], and several clinical and laboratory factors, such as older age at onset, presence of anti-acetylcholine receptor (AChR) antibody, high antibody titers, and the presence of thymoma, were claimed to be associated with an increased risk of secondary generalization.…”

The effect of early prednisolone treatment on the generalization rate in ocular myasthenia gravis

“…With this argument in mind several groups have retrospectively investigated the generalization rate of their patients with newly diagnosed ocular MG (OMG) when either being treated with corticosteroids or when receiving no immunosuppressive medication at all [4,[9][10][11][12][13][14][15][16]. Six of the available seven small retrospective studies have identified a reduced generalization rate under steroids when assessed within the first 2 years of treatment with relative risks in the range from 0.14 to 0.32, whereas the seventh study observed an increased risk with corticosteroids [4,[9][10][11][12][13][14][15][16].…”

Ocular Myasthenia Analysis of Diagnostic and Treatment Options

“…Although this is based on retrospective analysis (Benatar andKaminski 2007, Bhanushali et al 2008). Dosing regimens vary but typically, 10-20 mg once a day is started and increased by 5-10 mg every 3 days until visual symptoms are improved significantly, which usually occurs in the first few weeks of therapy (Kupersmith et al 2003;Mee et al 2003;Papapetropoulos et al 2003). 60-80 mg per day is a maximum dose.…”