title: The effect of early prednisolone treatment on the generalization rate in ocular myasthenia gravis.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Clinical Neurology, Medical University of Vienna, Vienna, Austria.
authors.forename: H
authors.initials: H
authors.lastname: Zach
authors.forename: H
authors.initials: H
authors.lastname: Cetin
authors.forename: E
authors.initials: E
authors.lastname: Hilger
authors.forename: A
authors.initials: A
authors.lastname: Paul
authors.forename: B
authors.initials: B
authors.lastname: Wuschitz
authors.forename: R
authors.initials: R
authors.lastname: Jung
authors.forename: E
authors.initials: E
authors.lastname: Auff
authors.forename: F
authors.initials: F
authors.lastname: Zimprich
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001323:Autoantibodies / Q000097:blood; D001763:Blepharoptosis / Q000209:etiology / Q000503:physiopathology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D018450:Disease Progression; D005128:Eye Diseases / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology; D009157:Myasthenia Gravis / Q000188:drug therapy* / Q000503:physiopathology; D009801:Oculomotor Muscles / Q000503:physiopathology; D011239:Prednisolone / Q000627:therapeutic use*; D011729:Pyridostigmine Bromide / Q000627:therapeutic use; D011950:Receptors, Cholinergic / Q000276:immunology; D012189:Retrospective Studies; D018570:Risk Assessment
chemical_list: D000893:Anti-Inflammatory Agents; D001323:Autoantibodies; D002800:Cholinesterase Inhibitors; D007166:Immunosuppressive Agents; D011950:Receptors, Cholinergic; D011239:Prednisolone; D011729:Pyridostigmine Bromide