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Jeffrey Peterson, Rod Foroozan; Characteristics of ocular and extra-ocular symptoms in patients with myasthenia gravis presenting with isolated ptosis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4099.
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In this study, we sought to determine the timeframe of development of ocular and extra-ocular symptoms in patients with myasthenia gravis who initially present with isolated ptosis.
A retrospective chart review was performed on patients with myasthenia gravis (n=35). All patients tested positive for the acetylcholine receptor autoantibody. In patients who presented initially with ptosis, the duration between ptosis onset and development of other ocular symptoms (horizontal or vertical diplopia) or extra-ocular symptoms (e.g. weakness, shortness of breath) were recorded. Data were analyzed using basic statistical methods.
Of the 25 patients in this study who presented with isolated ptosis, 24 ultimately developed horizontal or vertical diplopia. In 21 of these patients the duration from onset of ptosis to onset of diplopia was available. The mean of this duration was 2.0 ± 1.3 months, with a range of 2 weeks to 3 years. None of the patients in this study who initially presented with diplopia developed ptosis. No patients in this study developed extra-ocular symptoms of myasthenia gravis, and none developed thyroid eye disease.
In the majority of patients with myasthenia gravis presenting with isolated ptosis, diplopia subsequently developed within 2-3 months. Interestingly, in this study, ptosis did not develop in patients with myasthenia gravis who initially presented with diplopia.
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