Clinical Evidence of Treatment for Ocular Myasthenia Gravis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHONG Jie ¹ ,  WU Bo ²

1. Department of Ophthalmonogy, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu 610072, China; 2. Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

WU Bo, Email: dragonwb@126.com

Keywords：

Ocular myasthenia gravis; Treatment; Clinical evidence

DOI：

10.7507/1672-2531.20100490

Video：

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Objective 　To collect evidence of treatment for the patients with ocular myasthenia gravis.
Methods 　We searched The Cochrane Library (Issue 1, 2010), PubMed (1966 to April, 2010), CNKI (1979 to April, 2010) and VIP (1989 to April 2010) to identify systematic reviews, randomized controlled trials, controlled clinical trials and prospective avaicohort studies about efficacy and safety of treatment for ocular myasthenia gravis.
Results 　We identified 2 guidelines, 5 systematic reviews and 4 observational studies on inhibitor of acetylcholinesterase, immunosuppressive agents, intravenous immunoglobulin, corticosteroids, and thymectomy for ocular myasthenia gravis. The first choice for ocular myasthenia gravis was inhibitor of acetylcholinesterase. When the symptom could not be remitted, the corticosteroids should be considered. Immunosuppressive agents might be added if the effect of corticosteroids was not good. Plasma exchange was not recommended. Thymectomy should be performed if the patients suffered from thymoma.
Conclusion 　The best clinical evidence can be available by the evidence-based method.

Citation： ZHONG Jie,WU Bo. Clinical Evidence of Treatment for Ocular Myasthenia Gravis. Chinese Journal of Evidence-Based Medicine, 2010, 10(6): 763-765. doi: 10.7507/1672-2531.20100490 Copy

1.	Barton JJ, Fouladvand M. Ocular aspects of myasthenia gravis. Semin Neurol, 2000, 20(1): 7-20.
2.	Skeie GO, Apostolski S, Evoli A, et al. Guidelines for treatment of autoimmune neuromuscular transmission disorders. Eur J Neurol, 2010, [Epub ahead of print].
3.	Benatar M, Kaminski HJ. Quality Standards Subcommittee of the American Academy of Neurology. Evidence report: the medical treatment of ocular myasthenia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2007, 68(24): 2144-2149.
4.	Gronseth GS, Barohn RJ. Practice parameter: thymectomy for autoimmune myasthenia gravis (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2000, 55(1): 7-15.
5.	Benatar M, Kaminski H. Medical and surgical treatment for ocular myasthenia. Cochrane Database Syst Rev, 2006, 19(2): CD005081.
6.	Hart IK, Sathasivam S, Sharshar T. Immunosuppressive agents for myasthenia gravis. Cochrane Database Syst Rev, 2007, 17(4):CD005224.
7.	Schneider-Gold C, Gajdos P, Toyka KV, et al. Corticosteroids for myasthenia gravis. Cochrane Database Syst Rev, 2005, 18(2):CD002828.
8.	Gajdos P, Chevret S, Toyka K. Intravenous immunoglobulin for myasthenia gravis. Cochrane Database Syst Rev. Cochrane Database Syst Rev, 2008, 23(1): CD002277.
9.	Kupersmith MJ, Ying G. Ocular motor dysfunction and ptosis in ocular myasthenia gravis: efects of treatment. Br J Ophthalmol, 2005, 89(10): 1330-1334．.
10.	Monsul NT, PatwaHS, KnorrAM, et al. The effect of prednisolie on the progression from oc ular to generalized myas thenia gravis. J Neurol Sci, 2004, 217(2): 131-133．.
11.	Kupersmith MJ, Latkany R, Homel P. Development of generalized disease at 2 years in patients with oc ular myasthenia gravis. Arch Neurol, 2003, 60(2): 243-248．.
12.	Sommer N, Sigg B, Melms A, et al. Ocular myasthenia gravis: response to long-term immunenosuppressive treatment. J Neurol Neurosurg Psychiatry, 1997, 62(2): 156-162.

1. Barton JJ, Fouladvand M. Ocular aspects of myasthenia gravis. Semin Neurol, 2000, 20(1): 7-20.
2. Skeie GO, Apostolski S, Evoli A, et al. Guidelines for treatment of autoimmune neuromuscular transmission disorders. Eur J Neurol, 2010, [Epub ahead of print].
3. Benatar M, Kaminski HJ. Quality Standards Subcommittee of the American Academy of Neurology. Evidence report: the medical treatment of ocular myasthenia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2007, 68(24): 2144-2149.
4. Gronseth GS, Barohn RJ. Practice parameter: thymectomy for autoimmune myasthenia gravis (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2000, 55(1): 7-15.
5. Benatar M, Kaminski H. Medical and surgical treatment for ocular myasthenia. Cochrane Database Syst Rev, 2006, 19(2): CD005081.
6. Hart IK, Sathasivam S, Sharshar T. Immunosuppressive agents for myasthenia gravis. Cochrane Database Syst Rev, 2007, 17(4):CD005224.
7. Schneider-Gold C, Gajdos P, Toyka KV, et al. Corticosteroids for myasthenia gravis. Cochrane Database Syst Rev, 2005, 18(2):CD002828.
8. Gajdos P, Chevret S, Toyka K. Intravenous immunoglobulin for myasthenia gravis. Cochrane Database Syst Rev. Cochrane Database Syst Rev, 2008, 23(1): CD002277.
9. Kupersmith MJ, Ying G. Ocular motor dysfunction and ptosis in ocular myasthenia gravis: efects of treatment. Br J Ophthalmol, 2005, 89(10): 1330-1334．.
10. Monsul NT, PatwaHS, KnorrAM, et al. The effect of prednisolie on the progression from oc ular to generalized myas thenia gravis. J Neurol Sci, 2004, 217(2): 131-133．.
11. Kupersmith MJ, Latkany R, Homel P. Development of generalized disease at 2 years in patients with oc ular myasthenia gravis. Arch Neurol, 2003, 60(2): 243-248．.
12. Sommer N, Sigg B, Melms A, et al. Ocular myasthenia gravis: response to long-term immunenosuppressive treatment. J Neurol Neurosurg Psychiatry, 1997, 62(2): 156-162.

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