Ocular myasthenia – symptoms, diagnostics, treatment Review article

Main Article Content

Emilia Nowowiejska
Radosław Różycki

Abstract

Myasthenia gravis (MG) is an autoimmune disease in which antibodies are damaging receptors of the neuromuscular junction. One of its main symptoms is ptosis, term that refers to the drooping of the eyelid that may lead to a reduction of the vision field and the compensatory chin-up position. Contrary to sensile (involutional) ptosis, in which surgical treatment is a method of choice, in case of ptosis with myasthenic aetilology, pharmacotherapy is recommended and surgery is relatively contraindicated. Surgical procedures are rarely performed, only in the case of stable ptosis and ineffectiveness of pharmacotherapy. Since the majority of isolated drooping eyelids of a different aetiology can be successfully surgically corrected, ruling out the diagnosis of myasthenia gravis is essential before deciding on appropriate treatment.

Article Details

How to Cite
1.
Nowowiejska E, Różycki R. Ocular myasthenia – symptoms, diagnostics, treatment. Ophthatherapy [Internet]. 2020Dec.15 [cited 2021Mar.8];7(4):288-94. Available from: https://www.journalsmededu.pl/index.php/ophthatherapy/article/view/1112
Section
Diagnostics

References

1. Bowling B. Kanski’s Clinical Approach, 8th ed. Edra Urban & Partner, Wrocław 2017: 41-5.
2. Nair AG, Patil-Chhablani P, Venkatramani D et al. Ocular myasthenia gravis: A review. Indian J Ophthalmol. 2014; 62(10): 985-91.
3. Mainak B, Hansa D, Debopam S. Neonatal myasthenia gravis. StatPearls [Internet]. 2020.
4. Kostera-Pruszczyk A. Postępowanie terapeutyczne w miastenii. Pol Przegl Neurol. 2013; 9(1): 11-5.
5. Kupersmith MJ, Latkany R, Homel P. Development of generalized disease at 2 years in patients with ocular miastenia gravis. Arch Neurol. 2003; 60: 243-8.
6. Sathasivam S. Diagnosis and management of myasthenia gravis. Prog Neurol Psychiatry. 2014: 6-14.
7. De Meel RHP, Raadsheer WF, van Zwet EW et al. Ocular Weakness in Myasthenia Gravis: Changes in Affected Muscles are a Distinct Clinical Feature. J Neuromuscul Dis. 2019; 6(3): 369-76.
8. Majerczak J, Żołądź JA, Duda K. Charakterystyka strukturalna, biochemiczna i funkcjonalna mięśni zewnętrznych gałki ocznej. Postępy Biologii Komórki. 2005; 32(3): 395-408.
9. Meriggioli MN, Sanders DB. Autoimmune myasthenia gravis emerging clinical and biological heterogeneity. Lancet Neurol. 2009; 8(5): 475-90.
10. Trobe JD. Szybkie rozpoznanie w okulistyce. Neurookulistyka. Elsevier Urban & Partner, Wrocław 2011: 104-6.
11. Emeryk-Szajewska B. Elektrofizjologiczna diagnostyka obwodowego układu nerwowego w zespołach paranowotworowych. Pol Przegl Neurol. 2008; 4(4): 190-8.
12. Monsul NT, Patwa HS, Knorr AM et al. The effects of prednisone on the progression from ocular to generalized myasthenia gravis. J Neurol Sci. 2004; 217: 131-3.