Department of Clinical Neurology, Medical University of Vienna, Vienna, Austria.
Eur J Neurol. 2013 Apr;20(4):708-13. doi: 10.1111/ene.12057. Epub 2012 Dec 25.
Several small retrospective studies have observed that patients with a purely ocular manifestation of myasthenia gravis (MG) are significantly less likely to convert to a generalized disease when treated early on with corticosteroids. However, given the limited number of reported patients in the literature these findings still remain controversial.
In order to increase the number of published cases, we performed a retrospective analysis on 44 patients with newly diagnosed ocular MG who were subsequently either treated with corticosteroids or received no immunosuppressive therapy at all. The generalization rate was assessed at the end of a 2-year follow-up period.
Whereas none of 17 treated patients generalized, 11 of 27 (41%) untreated patients developed generalized symptoms. The difference between the groups was significant (P=0.003).
Our results agree well with previous studies on this issue. Taken together, published data indicate risk ratios for generalization of below 0.32 under corticosteroid treatment in comparison to untreated patients.
几项小型回顾性研究观察到，在早期接受皮质类固醇治疗的单纯眼肌型重症肌无力（MG）患者，转化为全身性疾病的可能性显著降低。然而，鉴于文献中报告的患者数量有限，这些发现仍然存在争议。
为了增加已发表病例的数量，我们对 44 例新诊断的眼肌型 MG 患者进行了回顾性分析，随后这些患者要么接受皮质类固醇治疗，要么根本不接受免疫抑制治疗。在 2 年的随访期结束时评估了疾病的泛化率。
17 例接受治疗的患者中无一例出现泛化，而 27 例未接受治疗的患者中有 11 例（41%）出现了全身性症状。两组之间的差异具有统计学意义（P=0.003）。
我们的结果与之前关于这个问题的研究结果一致。综合已发表的数据表明，与未接受治疗的患者相比，皮质类固醇治疗的疾病泛化风险比为 0.32 以下。
