Low conversion rate of ocular to generalized myasthenia gravis in Singapore |
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| Authors: | Kelvin Y. Teo MBBS Sharon L. Tow FRCSEd Benjamin Haaland PhD Tushar D. Gosavi MRCP LOO Jing‐Liang FRCS LO Yew Long FAMS Dan Milea MD PhD |
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| Affiliation: | 1. Singapore National Eye Centre;2. Singapore National Eye Centre, Singapore Eye Research Institute and Duke‐NUS, Singapore;3. Population Health Sciences, University of Utah, USA and Duke‐NUS, Singapore;4. National Neuroscience Institute, Singapore General Hospital, Singapore;5. Singapore National Eye CentreSingapore Eye Research Institute, Yong Yoo Lin Medical School and Duke‐NUS |
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| Abstract: | Introduction: Ocular myasthenia gravis (OMG) is a common condition of the neuromuscular junction that may convert to generalized myasthenia gravis (GMG). Our aim in this study was to determine the conversion rate and predictive factors for generalization in OMG, in an Asian population. Methods: The investigation consisted of a retrospective study of OMG patients with a minimum 2 years of follow‐up. Results: Among 191 patients with OMG, 155 had the minimum 2‐year follow‐up. The conversion rate at median follow‐up (40.8 months) was 10.6% (95% confidence interval 7.9%–13.3%), and at the 2‐year follow‐up it was 7.7% (95% confidence interval 5.6%–9.8%). At baseline, the predictive factors for generalization were positive acetylcholine receptor antibodies (hazard ratio 3.71, P = 0.024), positive repetitive nerve stimulation (RNS) studies (hazard ratio 4.42, P = 0.003), and presence of radiologically presumed or pathologically confirmed thymoma (hazard ratio 3.10, P = 0.013). Discussion: The conversion rate of OMG to GMG in Asian patients is low, as predicted by presence of acetylcholine receptor antibodies, presence of thymoma, and positive RNS studies. Muscle Nerve 57 : 756–760, 2018 |
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| Keywords: | acetylcholine receptor antibodies diplopia generalization myasthenia gravis ocular myasthenia gravis ptosis |
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