Prognosis of ocular myasthenia in Korea

A retrospective multicenter analysis of 202 patients

Yoon Ho Hong, Seok Beom Kwon, Byung Jo Kim, Byoung Joon Kim, Seung Hyun Kim, Jong Kuk Kim, Kyung Seok Park, Ki Jong Park, Jung Joon Sung, Eun Hee Sohn, Yeong Bae Lee, Dushin Jeong, In Soo Joo, Byung Ok Choi, Young Chul Choi

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Objectives: The aims of this study were to obtain data on the frequency with which Korean patients with autoimmune myasthenia gravis (MG) present solely with ocular disturbances and progress to develop generalized disease and to identify the prognostic factors associated with secondary generalization. Methods: We conducted a retrospective multicenter survey in which a total of 376 adult patients who were newly diagnosed with MG from 2000 through 2005 were reviewed for analysis. Patients with ocular MG at the time of symptom presentation (n = 202, 53.7%) were divided into two subgroups according to their prognosis: the patients whose disease remained ocular throughout the follow-ups were placed in the OMG-R group, and the patients who progressed to develop generalized disease were placed in the OMG-G group. Clinical characteristics and laboratory findings were compared between the two subgroups. Results: Secondary generalization developed in 47 (23.3%) of the 202 study subjects, mostly within the first 6 months after symptom presentation, while the disease remained ocular throughout the follow-up duration (median 11.8 months) in the remaining 155 patients (76.7%). AChR antibody, abnormal repetitive nerve stimulation tests (RNST) and thymoma were more frequently observed in the patients in the OMG-G group than in those in the OMG-R group (p < 0.01 in all). In seropositive cases, the titers of AChR antibody were also significantly higher in the OMG-G group than in the OMG-R group (median, 3.8 nM vs. 6.4 nM; p < 0.05). Cox proportional hazards regression analyses showed that early oral prednisolone treatment significantly reduced the risk of secondary generalization (HR, 0.24; 95% CI, 0.11-0.56), whereas abnormal AChR antibody (HR, 5.34; 95% CI, 1.60-17.8) and thymoma (HR, 2.32; 95% CI, 1.21-4.45) were predictive of the development of secondary generalization. Conclusions: Our findings suggest that several factors, including the AChR antibody, thymoma, early corticosteroid treatment, and possibly latent neuromuscular abnormality revealed by RNST, may have an impact on the risk of developing generalized disease in Korean patients presenting with ocular myasthenia.

Original languageEnglish
Pages (from-to)10-14
Number of pages5
JournalJournal of the Neurological Sciences
Volume273
Issue number1-2
DOIs
Publication statusPublished - 2008 Oct 15

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Korea
Thymoma
Myasthenia Gravis
Antibodies
Prednisolone
Adrenal Cortex Hormones
Regression Analysis
Therapeutics

Keywords

  • AChR antibody
  • Ocular myasthenia gravis
  • Prognosis
  • Repetitive nerve stimulation test
  • Thymoma

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Prognosis of ocular myasthenia in Korea : A retrospective multicenter analysis of 202 patients. / Hong, Yoon Ho; Kwon, Seok Beom; Kim, Byung Jo; Kim, Byoung Joon; Kim, Seung Hyun; Kim, Jong Kuk; Park, Kyung Seok; Park, Ki Jong; Sung, Jung Joon; Sohn, Eun Hee; Lee, Yeong Bae; Jeong, Dushin; Joo, In Soo; Choi, Byung Ok; Choi, Young Chul.

In: Journal of the Neurological Sciences, Vol. 273, No. 1-2, 15.10.2008, p. 10-14.

Research output: Contribution to journalArticle

Hong, YH, Kwon, SB, Kim, BJ, Kim, BJ, Kim, SH, Kim, JK, Park, KS, Park, KJ, Sung, JJ, Sohn, EH, Lee, YB, Jeong, D, Joo, IS, Choi, BO & Choi, YC 2008, 'Prognosis of ocular myasthenia in Korea: A retrospective multicenter analysis of 202 patients', Journal of the Neurological Sciences, vol. 273, no. 1-2, pp. 10-14. https://doi.org/10.1016/j.jns.2008.05.023
Hong, Yoon Ho ; Kwon, Seok Beom ; Kim, Byung Jo ; Kim, Byoung Joon ; Kim, Seung Hyun ; Kim, Jong Kuk ; Park, Kyung Seok ; Park, Ki Jong ; Sung, Jung Joon ; Sohn, Eun Hee ; Lee, Yeong Bae ; Jeong, Dushin ; Joo, In Soo ; Choi, Byung Ok ; Choi, Young Chul. / Prognosis of ocular myasthenia in Korea : A retrospective multicenter analysis of 202 patients. In: Journal of the Neurological Sciences. 2008 ; Vol. 273, No. 1-2. pp. 10-14.
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AU - Hong, Yoon Ho

AU - Kwon, Seok Beom

AU - Kim, Byung Jo

AU - Kim, Byoung Joon

AU - Kim, Seung Hyun

AU - Kim, Jong Kuk

AU - Park, Kyung Seok

AU - Park, Ki Jong

AU - Sung, Jung Joon

AU - Sohn, Eun Hee

AU - Lee, Yeong Bae

AU - Jeong, Dushin

AU - Joo, In Soo

AU - Choi, Byung Ok

AU - Choi, Young Chul

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N2 - Objectives: The aims of this study were to obtain data on the frequency with which Korean patients with autoimmune myasthenia gravis (MG) present solely with ocular disturbances and progress to develop generalized disease and to identify the prognostic factors associated with secondary generalization. Methods: We conducted a retrospective multicenter survey in which a total of 376 adult patients who were newly diagnosed with MG from 2000 through 2005 were reviewed for analysis. Patients with ocular MG at the time of symptom presentation (n = 202, 53.7%) were divided into two subgroups according to their prognosis: the patients whose disease remained ocular throughout the follow-ups were placed in the OMG-R group, and the patients who progressed to develop generalized disease were placed in the OMG-G group. Clinical characteristics and laboratory findings were compared between the two subgroups. Results: Secondary generalization developed in 47 (23.3%) of the 202 study subjects, mostly within the first 6 months after symptom presentation, while the disease remained ocular throughout the follow-up duration (median 11.8 months) in the remaining 155 patients (76.7%). AChR antibody, abnormal repetitive nerve stimulation tests (RNST) and thymoma were more frequently observed in the patients in the OMG-G group than in those in the OMG-R group (p < 0.01 in all). In seropositive cases, the titers of AChR antibody were also significantly higher in the OMG-G group than in the OMG-R group (median, 3.8 nM vs. 6.4 nM; p < 0.05). Cox proportional hazards regression analyses showed that early oral prednisolone treatment significantly reduced the risk of secondary generalization (HR, 0.24; 95% CI, 0.11-0.56), whereas abnormal AChR antibody (HR, 5.34; 95% CI, 1.60-17.8) and thymoma (HR, 2.32; 95% CI, 1.21-4.45) were predictive of the development of secondary generalization. Conclusions: Our findings suggest that several factors, including the AChR antibody, thymoma, early corticosteroid treatment, and possibly latent neuromuscular abnormality revealed by RNST, may have an impact on the risk of developing generalized disease in Korean patients presenting with ocular myasthenia.

AB - Objectives: The aims of this study were to obtain data on the frequency with which Korean patients with autoimmune myasthenia gravis (MG) present solely with ocular disturbances and progress to develop generalized disease and to identify the prognostic factors associated with secondary generalization. Methods: We conducted a retrospective multicenter survey in which a total of 376 adult patients who were newly diagnosed with MG from 2000 through 2005 were reviewed for analysis. Patients with ocular MG at the time of symptom presentation (n = 202, 53.7%) were divided into two subgroups according to their prognosis: the patients whose disease remained ocular throughout the follow-ups were placed in the OMG-R group, and the patients who progressed to develop generalized disease were placed in the OMG-G group. Clinical characteristics and laboratory findings were compared between the two subgroups. Results: Secondary generalization developed in 47 (23.3%) of the 202 study subjects, mostly within the first 6 months after symptom presentation, while the disease remained ocular throughout the follow-up duration (median 11.8 months) in the remaining 155 patients (76.7%). AChR antibody, abnormal repetitive nerve stimulation tests (RNST) and thymoma were more frequently observed in the patients in the OMG-G group than in those in the OMG-R group (p < 0.01 in all). In seropositive cases, the titers of AChR antibody were also significantly higher in the OMG-G group than in the OMG-R group (median, 3.8 nM vs. 6.4 nM; p < 0.05). Cox proportional hazards regression analyses showed that early oral prednisolone treatment significantly reduced the risk of secondary generalization (HR, 0.24; 95% CI, 0.11-0.56), whereas abnormal AChR antibody (HR, 5.34; 95% CI, 1.60-17.8) and thymoma (HR, 2.32; 95% CI, 1.21-4.45) were predictive of the development of secondary generalization. Conclusions: Our findings suggest that several factors, including the AChR antibody, thymoma, early corticosteroid treatment, and possibly latent neuromuscular abnormality revealed by RNST, may have an impact on the risk of developing generalized disease in Korean patients presenting with ocular myasthenia.

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KW - Repetitive nerve stimulation test

KW - Thymoma

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