Abstract
Fifty percent of ocular myasthenia gravis (OMG) patients will progress to generalized
myasthenia, 90% within 3 years from the onset of ocular symptoms. This study was performed
to determine whether treatment with oral prednisone initiated and completed within
2 years from the onset of ocular symptoms would affect the progression of ocular myasthenia
to generalized myasthenia gravis (GMG). Fifty-six patients were included in this review,
with 27 patients in the prednisone-treated group and 29 patients in the untreated
group. The treated group was initiated on 60 mg of prednisone daily with a slow taper
over 3–6 months. At 2 years, significantly fewer patients in the treated group (3
of 27) progressed to generalized myasthenia when compared to the untreated group (10
of 29) (χ2, p=0.04). Our results suggest that the early use of steroids may decrease progression
of ocular to generalized myasthenia gravis. The decision to use steroids should be
considered early in the course of patients diagnosed with ocular myasthenia gravis.
This study should be considered preliminary and a prospective trial is warranted to
confirm our observations.
Keywords
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Article info
Publication history
Accepted:
August 25,
2003
Received in revised form:
August 21,
2003
Received:
March 24,
2003
Identification
Copyright
© 2003 Elsevier B.V. Published by Elsevier Inc. All rights reserved.