Taiwan Journal of Ophthalmology

REVIEW ARTICLE
Year
: 2018  |  Volume : 8  |  Issue : 2  |  Page : 67--73

Update on ocular myasthenia gravis in Taiwan


Chao-Wen Lin1, Ta-Ching Chen1, Jieh-Ren Jou2, Lin-Chung Woung3 
1 National Taiwan University Hospital, Taipei City, Taiwan
2 National Taiwan University Hospital, Taipei City; Changhua Christian Hospital, Changhua, Taiwan
3 National Taiwan University Hospital; Taipei City Hospital, Taipei City, Taiwan

Correspondence Address:
Prof. Lin-Chung Woung
No. 145, Zhengzhou Road, Datong, Taipei City 10341
Taiwan

Myasthenia gravis (MG) is an autoimmune disease involving the neuromuscular junction. Autoantibodies to the acetylcholine receptor or, less frequently, to muscle-specific kinase, attack against the postsynaptic junctional proteins, resulting in fluctuating and variable weakness of muscles. Extraocular, levator palpebrae superioris, and orbicularis oculi muscles are particularly susceptible. The majority of patients with MG present with purely ocular symptoms including ptosis and diplopia initially. About half of these patients progress to generalized disease within 2 years. The prevalence of MG in Taiwan is 140 per million with male to female ratio of 0.7. The incidence rate is higher in the elderly. Several immune-related diseases such as lymphoid malignancy, diabetes, and thyroid diseases are associated with MG in the national population-based studies in Taiwan. Ice pack test, rest test, Tensilon/neostigmine test, circulating antibody measurement, and electrophysiological studies are useful diagnostic tools with variable sensitivity and specificity. For the patients with ocular MG, acetylcholinesterase inhibitors are usually the first-line treatment. Corticosteroids and immunosuppressant could provide better disease control and may reduce the risk of conversion to generalized form although there is still some controversy. A thymectomy is also beneficial for ocular MG, especially in refractory cases. The correction of ptosis and strabismus surgery could improve the visual outcome but should be performed only in stable disease.


How to cite this article:
Lin CW, Chen TC, Jou JR, Woung LC. Update on ocular myasthenia gravis in Taiwan.Taiwan J Ophthalmol 2018;8:67-73


How to cite this URL:
Lin CW, Chen TC, Jou JR, Woung LC. Update on ocular myasthenia gravis in Taiwan. Taiwan J Ophthalmol [serial online] 2018 [cited 2019 Nov 12 ];8:67-73
Available from: http://www.e-tjo.org/article.asp?issn=2211-5056;year=2018;volume=8;issue=2;spage=67;epage=73;aulast=Lin;type=0