Quality of life in purely ocular myasthenia in Japan

Shigeaki Suzuki, Hiroyuki Murai, Tomihiro Imai, Yuriko Nagane, Masayuki Masuda, Emiko Tsuda, Shingo Konno, Satoru Oji, Shunya Nakane, Masakatsu Motomura, Norihiro Suzuki, Kimiaki Utsugisawa

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Since there has been no conclusive evidence regarding the treatment of ocular myasthenia, treatment guidelines were recently issued by the European Federation of Neurological Societies/European Neurological Society (EFNS/ENS). However, the therapeutic outcomes concerning the quality-of-life (QOL) of patients with ocular myasthenia are not yet fully understood.Methods: We investigated the therapeutic outcomes of patients with purely ocular myasthenia in a multicenter cross-sectional survey in Japan. To evaluate the severity of ocular symptoms, we used the ocular-quantitative MG (QMG) score advocated by Myasthenia Gravis Foundation of America. We used the Japanese translated version of the MG-QOL15, a self-appraised scoring system.Results: Of 607 myasthenia gravis (MG) patients with an observation-duration of illness ≥ 2 years, the cases of 123 patients (20%) were limited to ocular muscles (purely ocular myasthenia). During the entire clinical course, 81 patients experienced both ptosis and diplopia, 36 had ptosis alone, and six had diplopia alone. Acetyl-cholinesterase inhibitors and prednisolone were used in 98 and 52 patients, respectively. Treatment improved ocular symptoms, with the mean reduction in ocular-QMG score of 2.3 ± 1.8 points. However, 47 patients (38%) failed to gain minimal manifestation or a better status. Patients with unfavorable outcomes also self-reported severe QOL impairment. Multivariate analyses showed that the pretreatment ocular-QMG score was associated with unfavorable outcomes, but not associated with the patient's QOL.Conclusion: A treatment strategy designed in accord with a patient's ocular presentation must be considered in order to improve ocular symptoms and the patient's QOL.

Original languageEnglish
Article number142
JournalBMC Neurology
Volume14
Issue number1
DOIs
Publication statusPublished - 2014 Jul 5

Keywords

  • Ocular myasthenia
  • Ocular-quantitative myasthenia gravis score
  • Quality-of-life
  • Therapeutic outcome

ASJC Scopus subject areas

  • Clinical Neurology

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    Suzuki, S., Murai, H., Imai, T., Nagane, Y., Masuda, M., Tsuda, E., Konno, S., Oji, S., Nakane, S., Motomura, M., Suzuki, N., & Utsugisawa, K. (2014). Quality of life in purely ocular myasthenia in Japan. BMC Neurology, 14(1), [142]. https://doi.org/10.1186/1471-2377-14-142