PDF(Pubmed)
Abstract：
UNASSIGNED: Treatment for ocular myasthenia gravis (OMG) has not yet been well established. Few reports have been published on the clinical practice and outcomes of OMG.
UNASSIGNED: We investigated treatment of OMG and its outcomes in Japan.We investigated treatment of OMG and its outcomes in Japan.
UNASSIGNED: We performed a retrospective cross-sectional survey of OMG patients from eight hospitals in Japan.
UNASSIGNED: Clinical information, including sex, age at onset, initial symptoms, autoantibodies, clinical course, treatment history, complications, and outcomes, was obtained. In addition, we recorded the total number of patients with MG and OMG separately.
UNASSIGNED: In total, 135 patients with OMG (67 men, 68 women) were included. Treatment of OMG was not simple and involved various immunotherapeutic strategies. Eight patients went into remission spontaneously without immunotherapy. A total of 117 patients showed improvements after treatment, whereas 10 patients showed refractory responses to treatment. Overall outcomes were good; however, symptoms persisted in 60.7% of patients even after treatment. Among 90 patients who received immunotherapy, only two showed a refractory response. Meanwhile, for 45 patients who did not receive immunotherapy, 8 were refractory. Thus, the rate of refractory disease in the group with immunotherapy was significantly lower (p = 0.001, u-test) than in the group without immunotherapy. The proportion of generalized MG patients among all MG cases was low in medical centers where immunotherapy for OMG was frequently performed.
UNASSIGNED: Although the overall prognosis for patients with OMG was good, symptoms remained in more than half of the patients. Immunotherapy, including corticosteroids, may be beneficial for patients with OMG.
UNASSIGNED: Is immunosuppressive therapy beneficial for myasthenia gravis patients with ocular symptoms only? Patients with ocular myasthenia gravis (OMG) have only eye symptoms for more than 2 years. Whether this condition is an initial stage of the disease before eventually progressing to generalized myasthenia gravis (gMG) is still uncertain. Different from gMG, OMG is not life-threatening. But eye symptoms often cause troublesome problems in life. Doctors have treated OMG patients similarly to patients with gMG. There is no standard clinical practice for OMG. In this study, we examined how patients with OMG were treated at eight different specialist centers in Japan. In 135 patients with OMG, 8 patients became symptom free without treatment, 117 patients showed improvements after treatment, whereas 10 patients did not get well. Overall outcomes were good, but symptoms remained in 60.7% of patients even after treatment. Among 90 patients who received one or more immunotherapies, only 2 did not get well. Meanwhile, for 45 patients who did not receive immunotherapy, 8 remained ill. We found that treatment of OMG was not simple and often needed multiple immunotherapies. Administering immunotherapy, including corticosteroids, may be beneficial for patients with OMG.
UNASSIGNED: We investigated treatment of OMG and its outcomes in Japan.We investigated treatment of OMG and its outcomes in Japan.
UNASSIGNED: We performed a retrospective cross-sectional survey of OMG patients from eight hospitals in Japan.
UNASSIGNED: Clinical information, including sex, age at onset, initial symptoms, autoantibodies, clinical course, treatment history, complications, and outcomes, was obtained. In addition, we recorded the total number of patients with MG and OMG separately.
UNASSIGNED: In total, 135 patients with OMG (67 men, 68 women) were included. Treatment of OMG was not simple and involved various immunotherapeutic strategies. Eight patients went into remission spontaneously without immunotherapy. A total of 117 patients showed improvements after treatment, whereas 10 patients showed refractory responses to treatment. Overall outcomes were good; however, symptoms persisted in 60.7% of patients even after treatment. Among 90 patients who received immunotherapy, only two showed a refractory response. Meanwhile, for 45 patients who did not receive immunotherapy, 8 were refractory. Thus, the rate of refractory disease in the group with immunotherapy was significantly lower (p = 0.001, u-test) than in the group without immunotherapy. The proportion of generalized MG patients among all MG cases was low in medical centers where immunotherapy for OMG was frequently performed.
UNASSIGNED: Although the overall prognosis for patients with OMG was good, symptoms remained in more than half of the patients. Immunotherapy, including corticosteroids, may be beneficial for patients with OMG.
UNASSIGNED: Is immunosuppressive therapy beneficial for myasthenia gravis patients with ocular symptoms only? Patients with ocular myasthenia gravis (OMG) have only eye symptoms for more than 2 years. Whether this condition is an initial stage of the disease before eventually progressing to generalized myasthenia gravis (gMG) is still uncertain. Different from gMG, OMG is not life-threatening. But eye symptoms often cause troublesome problems in life. Doctors have treated OMG patients similarly to patients with gMG. There is no standard clinical practice for OMG. In this study, we examined how patients with OMG were treated at eight different specialist centers in Japan. In 135 patients with OMG, 8 patients became symptom free without treatment, 117 patients showed improvements after treatment, whereas 10 patients did not get well. Overall outcomes were good, but symptoms remained in 60.7% of patients even after treatment. Among 90 patients who received one or more immunotherapies, only 2 did not get well. Meanwhile, for 45 patients who did not receive immunotherapy, 8 remained ill. We found that treatment of OMG was not simple and often needed multiple immunotherapies. Administering immunotherapy, including corticosteroids, may be beneficial for patients with OMG.
摘要：
■眼部重症肌无力(OMG)的治疗尚未得到很好的确立。关于OMG的临床实践和结果的报道很少。
■我们调查了日本OMG的治疗及其结果。我们调查了日本OMG的治疗及其结果。
■我们对日本八家医院的OMG患者进行了回顾性横断面调查。
■临床信息，包括性,发病年龄,最初的症状,自身抗体,临床课程，治疗史,并发症,和结果，已获得。此外,我们分别记录了MG和OMG患者的总数.
■总共，135名OMG患者（67名男性，包括68名妇女）。OMG的治疗并不简单，涉及各种免疫治疗策略。八名患者在没有免疫疗法的情况下自发缓解。共有117名患者在治疗后表现出改善,而10例患者对治疗有难治性反应。总体结果很好；然而，即使在治疗后，60.7%的患者症状仍然存在。在90名接受免疫治疗的患者中，只有两个人表现出难治性反应。同时,45名没有接受免疫治疗的患者，8是耐火的。因此，免疫治疗组的难治性疾病发生率显著低于未免疫治疗组(p=0.001,u检验).在经常进行OMG免疫治疗的医疗中心，全身MG患者在所有MG病例中的比例较低。
■尽管OMG患者的总体预后良好，超过一半的患者仍有症状。免疫疗法,包括皮质类固醇,可能对OMG患者有益。
■免疫抑制治疗仅对有眼部症状的重症肌无力患者有益吗？眼部重症肌无力（OMG）患者仅有2年以上的眼部症状。这种情况是否在最终发展为广泛性重症肌无力（gMG）之前是疾病的初始阶段仍不确定。与GMG不同,OMG不会危及生命。但是眼睛症状经常会在生活中引起麻烦的问题。医生对OMG患者的治疗类似于gMG患者。OMG没有标准的临床实践。在这项研究中,我们在日本8个不同的专科中心检查了OMG患者的治疗情况.在135名OMG患者中，8例患者未经治疗无症状，117名患者在治疗后表现出改善，而10例患者没有好转。总体结果很好，但60.7%的患者即使在治疗后症状仍然存在。在90名接受一种或多种免疫疗法的患者中，只有2人没有好起来。同时,45名没有接受免疫治疗的患者，8病了我们发现OMG的治疗并不简单，通常需要多种免疫疗法。管理免疫疗法，包括皮质类固醇,可能对OMG患者有益。
■我们调查了日本OMG的治疗及其结果。我们调查了日本OMG的治疗及其结果。
■我们对日本八家医院的OMG患者进行了回顾性横断面调查。
■临床信息，包括性,发病年龄,最初的症状,自身抗体,临床课程，治疗史,并发症,和结果，已获得。此外,我们分别记录了MG和OMG患者的总数.
■总共，135名OMG患者（67名男性，包括68名妇女）。OMG的治疗并不简单，涉及各种免疫治疗策略。八名患者在没有免疫疗法的情况下自发缓解。共有117名患者在治疗后表现出改善,而10例患者对治疗有难治性反应。总体结果很好；然而，即使在治疗后，60.7%的患者症状仍然存在。在90名接受免疫治疗的患者中，只有两个人表现出难治性反应。同时,45名没有接受免疫治疗的患者，8是耐火的。因此，免疫治疗组的难治性疾病发生率显著低于未免疫治疗组(p=0.001,u检验).在经常进行OMG免疫治疗的医疗中心，全身MG患者在所有MG病例中的比例较低。
■尽管OMG患者的总体预后良好，超过一半的患者仍有症状。免疫疗法,包括皮质类固醇,可能对OMG患者有益。
■免疫抑制治疗仅对有眼部症状的重症肌无力患者有益吗？眼部重症肌无力（OMG）患者仅有2年以上的眼部症状。这种情况是否在最终发展为广泛性重症肌无力（gMG）之前是疾病的初始阶段仍不确定。与GMG不同,OMG不会危及生命。但是眼睛症状经常会在生活中引起麻烦的问题。医生对OMG患者的治疗类似于gMG患者。OMG没有标准的临床实践。在这项研究中,我们在日本8个不同的专科中心检查了OMG患者的治疗情况.在135名OMG患者中，8例患者未经治疗无症状，117名患者在治疗后表现出改善，而10例患者没有好转。总体结果很好，但60.7%的患者即使在治疗后症状仍然存在。在90名接受一种或多种免疫疗法的患者中，只有2人没有好起来。同时,45名没有接受免疫治疗的患者，8病了我们发现OMG的治疗并不简单，通常需要多种免疫疗法。管理免疫疗法，包括皮质类固醇,可能对OMG患者有益。
