Ocular Myasthenia Gravis in Slovak Republic

Martinka, Ivan; Cibulčík, František; Bednařík, Josef; Špalek, Peter

doi:10.14735/amcsnn2017190

Cited by 1 publication

(6 citation statements)

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“…7,22-25 Only 1 study demonstrated male sex to have an association with generalization. 26 Martinka et al reported a significant risk ratio of 1.23 of male sex with generalization. However, they also reported that female sex was associated with more severe OMG symptoms (risk ratio 1.2).…”

Section: Resultsmentioning

confidence: 99%

“…None of the patients were anti-MuSK+ in 2 studies. 26,35 On the opposite spectrum, 100% of the MuSK+ patients in 2 studies, 21,36 with 4 of 148 and 3 of 11 MuSK+ patients with OMG, reported to have converted to SGMG after an average of 4.7 years’ and 8.5 years’ duration of follow-up, respectively. Other studies had a MuSK+ OMG to SGMG conversion rate between 12.5% and 75%; in the study by Sabre et al 28 where 8 of 83 patients with OMG were MuSK+, 1 (12.5%) converted to SGMG after 47.4 months; and the study by Galassi et al 7 had 8 of 175 patients with OMG positive for MuSK, of which 6 (75%) converted to SGMG.…”

Section: Resultsmentioning

confidence: 99%

“…Nine of 31 studies reported on the frequency of anti-MuSK antibodies, 7,9,21,22,25,26,28,35,36 and only 1 study reported on the frequency of LRP4 antibodies. 28 Double seronegativity (DSN) was reported in 4 of 31 studies.…”

Section: Resultsmentioning

confidence: 99%

“…Most of the studies (19/31) found no association with age of onset with generalization. Six studies found an association of SGMG with older age, 22,[25][26][27][28][29] whereas 3 studies found an association with younger age. 19,30,31 Two studies included only older populations, such as 70 years or older 32 and 65 years or older.…”

Section: Age Of Onsetmentioning

confidence: 95%

“…7,20,22,24,33,35,39,41,42 Six studies did not report on an analysis of association with SGMG. 19,26,32,[44][45][46] Four studies did not report on the presence or absence of thymic abnormalities. 28,30,31,40 Details are provided in eTable 4 (links.lww.com/WNL/D67).…”

Section: Thymus Imagingmentioning

confidence: 99%

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Clinical Characteristics Associated With Secondary Generalization in Patients With Ocular Myasthenia Gravis

Fang,

Bokre,

Wong

2023

Neurology

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Background and Objectives Ocular myasthenia gravis (OMG) is an autoimmune disorder resulting in ocular symptoms such as diplopia and ptosis. The proportion of patients who convert to secondary generalized myasthenia gravis (SGMG) reported in the literature has been varied. The aim of this systematic review was to determine the clinical characteristics of patients with OMG and the proportion of SGMG conversion. Methods We conducted an electronic database search for randomized controlled trials, prospective nonrandomized studies, observational studies, and retrospective studies in EMBASE, CENTRAL, MEDLINE, and Web of Science. We included studies with patients with OMG who initially presented with ocular symptoms and signs only and were seen in clinical practice, reporting on the characteristics and outcomes of SGMG. We excluded studies with pediatric and congenital myasthenia gravis populations. Eligible studies included articles written in any language and containing data on patients with OMG. The main outcome measured was the proportion of patients with OMG who converted to SGMG and risk factors associated with secondary generalization of OMG. Two independent reviewers screened titles and abstracts and extracted data from full texts, reporting findings according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The methodology was evaluated using the Joanna Briggs Institute critical appraisal forms. PROSPERO registration number: CRD2021285257. Results Thirty-one studies were included in the quantitative and qualitative analysis. The proportion of generalization ranged from 11% to 84%. The pooled proportion was 39% (95% CI 32%–47%, I 2 = 95.86%, p < 0.001 unweighted, low certainty). The pooled risk ratio of female sex for conversion to SGMG was 1.06 (95% CI 0.96–1.17, I 2 = 0% p = 0.614, 21 studies included, very low certainty), and the pooled risk ratio of acetylcholine receptor (AChR) positivity was 1.30 (95% CI 1.05–1.56, I 2 = 0% p = 0.455, 16 studies included, very low certainty). Discussion Risk factors such as female sex and anti-AChR positivity have been identified to have possible associations with SGMG, but there are not enough quality observational studies. There is a need for a prospective global database of patients with OMG, including all countries with different populations.

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