Treatment outcomes and predictive factors in pediatric ocular myasthenia gravis

Abstract

© 2015, Medical Association of Thailand. All Rights reserved. Objective: To determine demographic data, clinical presentations, investigations, treatment regimens, and clinical outcomes in pediatric ocular myasthenia gravis patients, and to find predictive factors for clinical outcomes such as resolution of disease, development of generalized symptoms, or final amblyopia. Material and Method: This retrospective descriptive study of the medical records of 14 patients (male 6, female 8) less than 15 years that had ocular myasthenia gravis at Chiang Mai University Hospital between January 2006 and December 2012 was done. Univariate analysis was used to evaluate the predictive factors for clinical outcomes. Results: Mean age of onset was 6.96±4.65 years (range 0.58-14 years). All patients presented with ptosis (100%) and 67% with strabismus. The mean of total follow-up time is 6.30±3.84 years (range 1.25-14.25 years). None of the patients developed generalize myasthenia gravis. Only one patient had amblyopia at final presentation. Presenting age, gender, strabismus at initial presentation, and positive neostigmine or edrophonium test did not affect resolution of disease nor final amblyopia. Conclusion: The most common clinical presentation in pediatric OMG was ptosis. Most patients could control the disease only by medications. There were no predictive factors affecting resolution of disease nor final amblyopia.