Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2014 Jul 5:14:142.
doi: 10.1186/1471-2377-14-142.

Quality of life in purely ocular myasthenia in Japan

Shigeaki Suzuki  1 , Hiroyuki Murai, Tomihiro Imai, Yuriko Nagane, Masayuki Masuda, Emiko Tsuda, Shingo Konno, Satoru Oji, Shunya Nakane, Masakatsu Motomura, Norihiro Suzuki, Kimiaki Utsugisawa
Affiliations
Multicenter Study

Quality of life in purely ocular myasthenia in Japan

Shigeaki Suzuki et al. BMC Neurol. .

Abstract

Background: Since there has been no conclusive evidence regarding the treatment of ocular myasthenia, treatment guidelines were recently issued by the European Federation of Neurological Societies/European Neurological Society (EFNS/ENS). However, the therapeutic outcomes concerning the quality-of-life (QOL) of patients with ocular myasthenia are not yet fully understood.

Methods: We investigated the therapeutic outcomes of patients with purely ocular myasthenia in a multicenter cross-sectional survey in Japan. To evaluate the severity of ocular symptoms, we used the ocular-quantitative MG (QMG) score advocated by Myasthenia Gravis Foundation of America. We used the Japanese translated version of the MG-QOL15, a self-appraised scoring system.

Results: Of 607 myasthenia gravis (MG) patients with an observation-duration of illness ≥ 2 years, the cases of 123 patients (20%) were limited to ocular muscles (purely ocular myasthenia). During the entire clinical course, 81 patients experienced both ptosis and diplopia, 36 had ptosis alone, and six had diplopia alone. Acetyl-cholinesterase inhibitors and prednisolone were used in 98 and 52 patients, respectively. Treatment improved ocular symptoms, with the mean reduction in ocular-QMG score of 2.3 ± 1.8 points. However, 47 patients (38%) failed to gain minimal manifestation or a better status. Patients with unfavorable outcomes also self-reported severe QOL impairment. Multivariate analyses showed that the pretreatment ocular-QMG score was associated with unfavorable outcomes, but not associated with the patient's QOL.

Conclusion: A treatment strategy designed in accord with a patient's ocular presentation must be considered in order to improve ocular symptoms and the patient's QOL.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of pre- and post-treatment ocular-quantitative myasthenia gravis (QMG) scores of the 123 patients with purely ocular myasthenia.
Figure 2
Figure 2
Scores on the 15 items of MG-QOL15-J. Statistical analyses were performed between the unfavorable (n = 47) and favorable (n = 76) outcome groups. †p < 0.05, #p < 0.01, and *p < 0.001.
See this image and copyright information in PMC

References

    1. Meriggioli MN, Sanders DB. Autoimmune myasthenia gravis: emerging clinical and biological heterogeneity. Lancet Neurol. 2009;8:475–490. - PMC - PubMed
    1. Evoli A, Batocchi AP, Minisci C, Di Schino C, Tonali P. Therapeutic options in ocular myasthenia gravis. Neuromuscul Disord. 2001;11:208–216. - PubMed
    1. Kaminski HJ, Li Z, Richmonds C, Lin F, Medof ME. Complement regulators in extraocular muscle and experimental autoimmune myasthenia gravis. Exp Neurol. 2004;189:333–342. - PubMed
    1. Grob D, Brunner N, Namba T, Pagala M. Lifetime course of myasthenia gravis. Muscle Nerve. 2008;37:141–149. - PubMed
    1. Bever CT Jr, Aquino AV, Penn AS, Lovelace RE, Rowland LP. Prognosis of ocular myasthenia. Ann Neurol. 1983;14:516–519. - PubMed

Publication types