Analysis of clinical features and outcomes in patients with ocular myasthenia gravis according to anti-acetylcholine receptor antibody-seropositivity.

IF 2.1 3区 医学 Q2 OPHTHALMOLOGY Japanese Journal of Ophthalmology Pub Date : 2024-10-02 DOI:10.1007/s10384-024-01125-8
Byung Joo Lee, Jimin Park, Hyosook Ahn, Hyun Taek Lim
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Abstract

Purpose: To comparatively analyze the clinical characteristics of patients with ocular myasthenia gravis (OMG) referred to an ophthalmology clinic, according to anti-acetylcholine receptor antibody (AchR Ab)-seropositivity.

Study design: Retrospective Cohort Study.

Methods: Medical records of patients with OMG who presented to a tertiary eye care center between 2003 and 2020 were retrospectively reviewed. Demographics, ophthalmologic characteristics, response to medical treatment, presence of autoimmune thyroid disease and thyroid autoantibody were compared between the AchR Ab seropositive and seronegative groups.

Results: A total of 130 patients with OMG were identified; among them, 46 patients (35.4%) had autoantibody against acetylcholine receptors. The mean age at symptom onset was 42.4 ± 18.9 years. There were no differences in mean age at symptom onset, gender ratio, and mean follow-up period between patients with seropositive and seronegative OMG. Graves ophthalmopathy was significantly more frequent in seronegative patients (p = 0.04), while thymic disease (p < 0.01) was more frequent in seropositive patients (p < 0.01). Among patients with seropositive OMG, 52.3% showed a good response to medical treatment, while only 31.4% of the seronegative patients were classified as good responders (p = 0.01). Thyroid dysfunction was found in 27.4% patients with OMG and the proportion of thyroid dysfunction was not different according to anti-acetylcholine receptor antibody-seropositivity.

Conclusion: Seropositivity to acetylcholine receptor antibody is associated with a better response to medical treatment and lower risk of concomitant autoimmune thyroid disease in patients with OMG.

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根据抗乙酰胆碱受体抗体血清阳性率分析眼肌型重症肌无力患者的临床特征和预后。
目的:根据抗乙酰胆碱受体抗体(AchR Ab)血清阳性率,比较分析转诊至眼科诊所的眼肌型重症肌无力(OMG)患者的临床特征:研究设计:回顾性队列研究:回顾性分析 2003 年至 2020 年期间在一家三级眼科医疗中心就诊的 OMG 患者的病历。比较AchR Ab血清阳性组和血清阴性组的人口统计学特征、眼科特征、对药物治疗的反应、是否存在自身免疫性甲状腺疾病和甲状腺自身抗体:共发现130名OMG患者,其中46名患者(35.4%)有乙酰胆碱受体自身抗体。患者发病时的平均年龄为(42.4 ± 18.9)岁。血清阳性和血清阴性 OMG 患者的平均发病年龄、性别比例和平均随访时间均无差异。血清反应阴性患者的巴塞杜氏眼病发病率明显更高(p = 0.04),而血清反应阳性患者的胸腺疾病发病率明显更高(p = 0.05):乙酰胆碱受体抗体血清阳性与 OMG 患者对药物治疗的较好反应和并发自身免疫性甲状腺疾病的较低风险有关。
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来源期刊
CiteScore
4.80
自引率
8.30%
发文量
65
审稿时长
6-12 weeks
期刊介绍: The Japanese Journal of Ophthalmology (JJO) was inaugurated in 1957 as a quarterly journal published in English by the Ophthalmology Department of the University of Tokyo, with the aim of disseminating the achievements of Japanese ophthalmologists worldwide. JJO remains the only Japanese ophthalmology journal published in English. In 1997, the Japanese Ophthalmological Society assumed the responsibility for publishing the Japanese Journal of Ophthalmology as its official English-language publication. Currently the journal is published bimonthly and accepts papers from authors worldwide. JJO has become an international interdisciplinary forum for the publication of basic science and clinical research papers.
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