TY - JOUR
T1 - Beneficial effects of corticosteroids on ocular myasthenia gravis
AU - Kupersmith, Mark J.
AU - Moster, Mark
AU - Bhiiiyan, Sam
AU - Warren, Floyd
AU - Weinberg, Harold
PY - 1996/8
Y1 - 1996/8
N2 - Objective: To determine if moderate- or low-dose corticosteroid therapy can reduce the diplopia and frequency of deterioration to generalized disease in ocular myasthenia gravis. Design: Retrospective record review. Setting: Two university-based neuro-ophthalmology services. Patients: All 32 patients with ocular myasthenia gravis, treated with prednisone, followed up for a minimum of 2 years were included. Patients were treated with 1 or more courses of daily prednisone (highest initial dose, 40-80 mg) gradually withdrawn over 4 to 6 weeks. Subsequently, in 6 patients, 2.5 to 20 mg of prednisone was given on alternate day. Outcome Measures: Diplopia in the primary position or downgaze diplopia and generalized myasthenia gravis after 2 years of follow-up. Results: Diplopia, which was initially found in the primary position in 29 patients and in the downgaze position in 26 patients, was absent in 21 patients at 2 years. Generalized myasthenia gravis occurred in 3 patients at 2 years. Elevated serum acetylcholine receptor antibody levels and abnormal electromyography findings were not predictive of worsening. No patient experienced a major steroid complication. Conclusions: Moderate-dose daily prednisone for 4 to 6 weeks, followed by low-dose alternate-day therapy as needed, can control the diplopia in patients with ocular myasthenia gravis. The frequency of deterioration to generalized myasthenia gravis at 2 years may be reduced; 9.4% in this study compared with more than 40% previously reported frequency. Corticosteroids may be useful even when ocular motor dysfunction is not normalized.
AB - Objective: To determine if moderate- or low-dose corticosteroid therapy can reduce the diplopia and frequency of deterioration to generalized disease in ocular myasthenia gravis. Design: Retrospective record review. Setting: Two university-based neuro-ophthalmology services. Patients: All 32 patients with ocular myasthenia gravis, treated with prednisone, followed up for a minimum of 2 years were included. Patients were treated with 1 or more courses of daily prednisone (highest initial dose, 40-80 mg) gradually withdrawn over 4 to 6 weeks. Subsequently, in 6 patients, 2.5 to 20 mg of prednisone was given on alternate day. Outcome Measures: Diplopia in the primary position or downgaze diplopia and generalized myasthenia gravis after 2 years of follow-up. Results: Diplopia, which was initially found in the primary position in 29 patients and in the downgaze position in 26 patients, was absent in 21 patients at 2 years. Generalized myasthenia gravis occurred in 3 patients at 2 years. Elevated serum acetylcholine receptor antibody levels and abnormal electromyography findings were not predictive of worsening. No patient experienced a major steroid complication. Conclusions: Moderate-dose daily prednisone for 4 to 6 weeks, followed by low-dose alternate-day therapy as needed, can control the diplopia in patients with ocular myasthenia gravis. The frequency of deterioration to generalized myasthenia gravis at 2 years may be reduced; 9.4% in this study compared with more than 40% previously reported frequency. Corticosteroids may be useful even when ocular motor dysfunction is not normalized.
UR - http://www.scopus.com/inward/record.url?scp=0029845381&partnerID=8YFLogxK
U2 - 10.1001/archneur.1996.00550080128020
DO - 10.1001/archneur.1996.00550080128020
M3 - Article
C2 - 8759987
AN - SCOPUS:0029845381
SN - 0003-9942
VL - 53
SP - 802
EP - 804
JO - Archives of Neurology
JF - Archives of Neurology
IS - 8
ER -