Local use of dexamethasone in the treatment of ocular myasthenia gravis

Minghua Shi,Jing Cheng,Hongxing Ren,Yingjia Ye,Junping Zhou,Aijiao Qin

doi:10.1186/s12886-020-01697-2

Abstract

BackgroundAt present, patients with ocular myasthenia gravis (OMG) are typically treated with systemic drugs. We investigated the use of dexamethasone injected in the peribulbar region or extraocular muscle to treat patients with OMG.MethodsPatients with OMG were given dexamethasone via peribulbar injection or direct injection into the main paralyzed extraocular muscles, once a week, for 4–6 weeks. The severity of diplopia, blepharoptosis, eye position, and eye movement were evaluated before and after treatment. The duration of follow-up time was ≥6 months.ResultsAmong the 14 patients with OMG who received this treatment, mean age was 38.7 ± 29.7 years. After treatment, symptoms were relieved in 12 patients (85.7%), 1 patient (7.1%) had partial response to treatment, and 1 patient (7.1%) had no response. Two patients (14.2%) experienced symptom recurrence during the follow-up period.ConclusionsDexamethasone peribulbar or extraocular muscle injection is effective in the treatment of patients with OMG and may replace systemic drug therapy.Trial registrationChinese Clinical Trial Registry, ChiCTR2000038863, October 7, 2020.Retrospectively registered.

Highlights

At present, patients with ocular myasthenia gravis (OMG) are typically treated with systemic drugs
Patients who came to our hospital during the period from August 2016 to May 2019 were diagnosed with OMG based on the symptoms presented and the results of the neostigmine test
During the period from August 2016 to May 2019, 20 patients at our hospital were diagnosed with Myasthenia gravis (MG)

Summary

Introduction

Patients with ocular myasthenia gravis (OMG) are typically treated with systemic drugs. About 60% MG known as simple OMG [3,4,5]. Even patients with OMG in whom symptoms were limited to the eyes were treated with systemic drugs, including acetylcholinesterase inhibitors, corticosteroids, immunosuppressants, immunomodulating agents and, recently, vascular growth factor inhibitors [7,8,9]. Among these treatments, oral acetylcholinesterase inhibitors and corticosteroids were used most commonly [7,8,9]. Any type of systemic medication is likely to induce adverse reactions

Methods

Results

Conclusion