Unit of Neurophthalmology, Consorci Parc de Salut MAR de Barcelona, Barcelona, Spain.
Department of Ophthalmology, Universitat Autònoma de Barcelona, Barcelona, Spain.
J Binocul Vis Ocul Motil. 2021 Apr-Jun;71(2):71-76. doi: 10.1080/2576117X.2021.1904097. Epub 2021 Apr 20.
: To assess the value of measuring diplopia before and after pyridostigmine intake to differentiate myasthenia gravis from sagging eye syndrome.To establish a threshold for a positive response to pyridostigmine in the diagnosis of myasthenia gravis.: 15 patients with myasthenia gravis and 15 with sagging eye syndrome diplopia were evaluated. Diplopia was measured in five positions (upgaze, downgaze, right gaze, left gaze, and primary position). After baseline measurements, the patient received a single dose (60 mg) of pyridostigmine. After 60 minutes the prism measure was performed again in five positions. Horizontal deviation, vertical deviation at distance was compared before and after a single dose of pyridostigmine in each gaze. Ocular deviations were compared between the two groups to identify the threshold with the highest sensitivity and specificity.: Differences between pretest deviations and posttest deviations in any gaze were found to be statistically significant only in the MG group. The optimum threshold for a positive response to pyridostigmine was a reduction of 2 prism diopters in any component in any gaze. Sensitivity for the detection of myasthenia diplopia was 80.00% and specificity was 86.67%.: Our results suggest that measuring diplopia with prisms before and after pyridostigmine administration can help to detect patients with suspected myasthenia.
评估吡啶斯的明摄入前后复视的价值，以区分重症肌无力与眼睑下垂综合征。建立吡啶斯的明诊断重症肌无力的阳性反应阈值。
评估 15 例重症肌无力和 15 例眼睑下垂综合征患者的复视。在 5 个位置（上视、下视、右视、左视和第一眼位）测量复视。在基线测量后，患者接受单次剂量（60mg）吡啶斯的明。60 分钟后，再次在 5 个位置进行棱镜测量。比较每个注视时单次吡啶斯的明前后水平偏差、远距垂直偏差。比较两组之间的眼偏差，以确定具有最高灵敏度和特异性的阈值。
发现任何注视时的术前偏差与术后偏差之间的差异仅在 MG 组具有统计学意义。吡啶斯的明阳性反应的最佳阈值为任何注视时任何成分的棱镜减少 2 个屈光度。检测重症肌无力复视的敏感性为 80.00%，特异性为 86.67%。
我们的结果表明，吡啶斯的明给药前后用棱镜测量复视有助于检测可疑重症肌无力患者。
