Age of onset and factors affecting treatment responses in Ocular Myasthenia Gravis

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Dr.Parinee Kemchoknatee

Rangsit University, Thailand

: Int J Ophthalmic Pathol

Abstract

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Background: Ocular Myasthenia Gravis (OMG) is an autoimmune disease which causes ptosis, diplopia, or both. It can be categorized as early- or late-onset, with differing presenting characteristics and prognoses. Currently, there is limited information available to compare characteristics and outcomes in onset groups in Thailand. Objective: To describe and compare baseline characteristics and outcomes in OMG patients classified by onset groups and to investigate the factors associated with the disease, especially in terms of treatment responses classified according to the MGFA Post-Intervention Status (MGFA-PIS). Methods: OMG patients diagnosed between January 2014 and March 2021 at Rajvithi Hospital, Thailand were categorized into 2 groups based on age of onset, and baseline characteristics were analyzed and compared. The treatment responses of each group in terms of time to achievement of Minimal Manifestations (MM) was analyzed. Results: Eighty-one patients (38 with early- and 43 with late-onset) were included, and the mean (SD) follow-up time was 35.85 months (17.25). There was no significant difference between the baseline characteristics of the two groups. A lowdose of Pyridostigmine was more commonly used in the early-onset group (p=0.01), while the mean dose of corticosteroids was significantly lower in the late-onset patients (p<0.001). We found that seropositivity of acetylcholine receptor antibody decreased the odds ratio of achievement of MM (OR 0.185, 95% CI; 0.043-0.789, p=0.023) and receiving a high dose of pyridostigmine (>120mg/day) increased the odds ratio of achieving it (OR 8.296, 95% CI; 2.136-32.226, p=0.002).

Biography

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Dr. Kemchoknatee is a lecturer and ophthalmologist at Ophthalmology Department, Rajavithi Hospital, Rangsit University, Thailand. She is certified the medical degree and residency in Ophthalmology at Mahidol University, Ramathibodi Hospital. She is a member of The Royal College of Ophthalmologists of Thailand. Since the year of 2020, she is an active international researcher in Neuro-Ophthalmology field. Her previous publications included optic nerve diseases (such as examining predictors of visual prognosis in Non-arteric ischemic optic neuropathy ,or evaluating visual outcome in 3 types of optic neuritis-related with Neuromyelitis optica spectrum disorder, multiple sclerosis ,or double seronegative optic neuritis) , the natural disease of myasthenia gravis in terms of progression to generalized myasthenia gravis or determination of treatment outcome in ocular myasthenia gravis, thyroid eye disease, and dysthyroid optic neuropathy in the aspects of either the diagnostic ability of MDCT or the determination of the efficacy of intravenous methyprednisolones in a Thai population. She also was selected as a speaker to provide a speech in her published research in many conferences.