title: Prognosis of Ocular Myasthenia Gravis: Retrospective Multicenter Analysis.
abstract: OBJECTIVE
  To calculate the rate and timing of conversion from ocular myasthenia gravis to generalized myasthenia gravis.
  
  
  METHODS
  Retrospective multicenter analysis.
  
  
  METHODS
  Patients included in the study were diagnosed with ocular myasthenia gravis without the presence of generalized disease at onset.
  
  
  METHODS
  We conducted a retrospective multicenter analysis. We reviewed charts of 158 patients who met diagnostic criteria for ocular myasthenia gravis. Patients were divided into 2 subgroups: an immunosuppressant treatment group and a nonimmunosuppressant treatment group. Timing of conversion to generalized disease and duration of follow-up also was evaluated. Additional data such as clinical symptoms at presentation, laboratory test results, and chest imaging results also were recorded.
  
  
  METHODS
  Conversion rates to generalized myasthenia at 2 years, effect of immunosuppression on conversion, and timing of conversion.
  
  
  RESULTS
  The 158-patient cohort included 76 patients who received immunosuppressant therapy; the remaining 82 patients did not. The overall conversion rate to generalized disease was 20.9%. At 2 years, generalized myasthenia developed in 8 of 76 patients in the treated group and in 15 of 82 patients in the nonimmunotherapy group (odds ratio, 0.52; 95% confidence interval, 0.20-1.32). Median time for conversion to generalized disease was 20 months in the nonimmunosuppressant group and 24 months in the immunosuppressant group. Conversion occurred after 2 years of symptom onset in 30% of patients.
  
  
  CONCLUSIONS
  Conversion rates from ocular to generalized myasthenia gravis may be lower than previously reported both in immunosuppressed and nonimmunosuppressed patients. A subset of patients may continue to convert to generalized disease beyond 2 years from onset of symptoms, and close monitoring should be continued.
authors.affiliation: Department of Ophthalmology, University of Alabama Birmingham, Birmingham, Alabama. Electronic address: lnagia@uab.edu.
authors.forename: Lina
authors.initials: L
authors.lastname: Nagia
authors.affiliation: Department of Neurology, Coimbra University Hospital Center, Praceta Professor Mota Pinto, Coimbra, Portugal.
authors.forename: Joao
authors.initials: J
authors.lastname: Lemos
authors.affiliation: Department of Neurology and Ophthalmology, Michigan State University, East Lansing, Michigan.
authors.forename: Khawla
authors.initials: K
authors.lastname: Abusamra
authors.affiliation: Department of Ophthalmology & Visual Science and Department of Neurology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Wayne T
authors.initials: WT
authors.lastname: Cornblath
authors.affiliation: Department of Ophthalmology and Department of Neurology, Michigan State University, East Lansing, Michigan.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Eggenberger
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D004172:Diplopia / Q000175:diagnosis; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007167:Immunotherapy; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000175:diagnosis* / Q000188:drug therapy; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D007166:Immunosuppressive Agents