Journal article
Treatment of Ocular Myasthenia Gravis
Current Treatment Options in Neurology, Vol.14(1), pp.103-112
02/2012
DOI: 10.1007/s11940-011-0151-8
PMID: 22037997
Abstract
Myasthenia gravis (MG) is an autoimmune disorder that is characterized by variable weakness and fatigability. Often, MG presents with only ocular symptoms such as ptosis and diplopia. Treatment of ocular MG is aimed at relieving the symptoms of ptosis and diplopia, as well as preventing the development of generalized MG symptoms. Immune suppression with steroids is often the main therapy. Steroid doses must be increased slowly because of a risk of precipitating myasthenic crisis. After achieving the highest target dose, steroids are then slowly tapered down to the lowest effective dose. Often, acetylcholinesterase inhibitors such as pyridostigmine and neostigmine are also employed to help control symptoms. When steroids are contraindicated, acetylcholinesterase inhibitors can be tried as the primary therapy. Steroid-sparing agents such as azathioprine and mycophenolate may also have a role in treating ocular MG. Other treatments for MG include plasmapheresis, intravenous immunoglobulin, and other immunosuppressive agents, but these are rarely required for ocular MG. Patients should also be evaluated for thymoma. Thymoma should be resected surgically. Ocular MG without thymoma is not usually treated with thymectomy. Topical agents may be useful as additional therapy for mild or moderate ptosis. Nonpharmacologic treatments include occlusive devices, prisms, eyelid supports, contact lenses, and (in long-standing, stable cases) strabismus surgery or eyelid elevation surgery.
Details
- Title: Subtitle
- Treatment of Ocular Myasthenia Gravis
- Creators
- Scott Haines - Department of Ophthalmology Virginia Commonwealth University Richmond VA 23298-0599 USAMatthew Thurtell - Department of Ophthalmology and Visual Sciences University of Iowa 200 Hawkins Drive, PFP Iowa City IA 52242-1091 USA
- Resource Type
- Journal article
- Publication Details
- Current Treatment Options in Neurology, Vol.14(1), pp.103-112
- Publisher
- Current Science Inc; New York
- DOI
- 10.1007/s11940-011-0151-8
- PMID
- 22037997
- ISSN
- 1092-8480
- eISSN
- 1534-3138
- Language
- English
- Date published
- 02/2012
- Academic Unit
- Neurology; Ophthalmology and Visual Sciences
- Record Identifier
- 9983979992602771
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