Surgical Treatment of Ocular Myasthenia Gravis

Abstract

Myasthenia gravis is a disorder of neuromuscular transmission which is related to acetylcholine (Ach) deficiency. The initial symptoms are common in the eyes with acute onset, including ptosis, diplopia, and extraocular muscle paralysis. The lesions are merely in the eyes without involvement of other nerves, which is called ocular myasthenia gravis (OMG). OMG may not develop into systematic disease in most cases. Thus, the ocular myasthenia gravis patients may usually present to the ophthalmologist for treatment. As a result, it is necessary for the ophthalmologist to master the pathogenesis, clinical manifestation, diagnostic criteria, and treatment of myasthenia gravis, and to differentiate it from other neurological diseases, so as to render accurate diagnosis and treatment plan promptly. In this section, we have a systematic introduction of clinical symptom, differential diagnosis, and drug therapy of OMG from the surgical prospective. At the same time, the approach, prognosis of thymectomy for myasthenia gravis, and application of minimal invasive surgery are introduced in detail, and the related symptoms and treatment methods of myasthenia gravis complicated by thymoma are also discussed, which can provide new ideas about the treatment of OMG for the ophthalmologist.