Efficacy and Safety of Low-to-Moderate Dose Oral Corticosteroid Treatment in Ocular Myasthenia Gravis

J Pediatr Ophthalmol Strabismus. 2018 Sep 20;55(5):339-342. doi: 10.3928/01913913-20180620-01. Epub 2018 Aug 3.

Abstract

Purpose: To evaluate the response to corticosteroid therapy as a primary treatment for ocular myasthenia gravis.

Methods: Patients diagnosed as having ocular myasthenia gravis by an acetylcholine receptor binding antibody test between January 2011 and September 2015 were included in the study and started receiving treatment with a corticosteroid. Patients with a blowout fracture, hyperthyroidism, diabetes mellitus, hypertension, cardiovascular disease, or history of strabismus surgery were excluded. Disappearance of diplopia and ptosis were considered a response to treatment.

Results: Methylprednisolone therapy was administered to 29 patients (19 men and 10 women; average age: 49 ± 16.5 years) as an initial treatment. A total of 6 patients were lost to follow-up. Twenty-three of 29 patients (82.6%) were regarded as having presented a response to treatment. The average treatment duration was 3 weeks for patients responding to primary treatment. Eight patients complained of adverse effects from steroid therapy such as heartburn, insomnia, weight gain, and myalgia.

Conclusions: A corticosteroid could be considered as an initial treatment for patients diagnosed as having ocular myasthenia gravis by an acetylcholine receptor binding antibody test. [J Pediatr Ophthalmol Strabismus. 2018;55(5):339-342.].

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Blepharoptosis / physiopathology
  • Diplopia / physiopathology
  • Female
  • Glucocorticoids / administration & dosage*
  • Humans
  • Male
  • Methylprednisolone / administration & dosage*
  • Middle Aged
  • Myasthenia Gravis / diagnosis
  • Myasthenia Gravis / drug therapy*
  • Myasthenia Gravis / physiopathology
  • Treatment Outcome

Substances

  • Glucocorticoids
  • Methylprednisolone