Efficacy of gaze photographs in diagnosing ocular myasthenia gravis

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background and Purpose The various tests that are routinely used to diagnose generalized myasthenia gravis, such as the edrophonium test, serum anti-acetylcholine-receptor antibodies (AChR-Ab), and repetitive nerve stimulation (RNS) tests, have lower diagnostic sensitivity in ocular myasthenia gravis (OMG). Diagnosing OMG becomes even more difficult when the clinical symptoms are subtle. There is no gold-standard diagnostic test available for OMG patients, and so this study compared the diagnostic sensitivity of gaze photographs with conventional tests in OMG. Methods Records of gaze photographs were available for 25 of 31 consecutive patients diagnosed with OMG. Each patient underwent a neuro-ophthalmologic examination, serum AChR-Ab, RNS, edrophonium test, ice tests, and the acquisition of gaze photographs. The margin reflex distance 1 (MRD1) was measured on each of the gaze photographs, with MRD1 <2 mm or an interlid MRD1 difference of ≥2 mm on any of the gaze photographs defined as a positive sign of OMG. The diagnostic sensitivities of the tests were assessed. Results The mean age at onset was 38.5 years (range, 2–76 years), and 13 patients (52%) were men. The diagnostic sensitivities of the RNS test, AChR-Ab test, gaze photographs, and ice test were 56%, 64%, 80%, and 73%, respectively. Conclusions The diagnostic sensitivity was higher for gaze photographs than for the other tests applied to OMG patients.

Original languageEnglish
Pages (from-to)333-338
Number of pages6
JournalJournal of Clinical Neurology (Korea)
Volume14
Issue number3
DOIs
StatePublished - Jul 2018

Fingerprint

Myasthenia Gravis
Cholinergic Receptors
Edrophonium
Reflex
Ice
Routine Diagnostic Tests
Antibodies
Serum
Age of Onset
Gold

Keywords

  • Diagnosis
  • Diagnostic sensitivity
  • Gaze photographs
  • Ocular myasthenia gravis

Cite this

@article{e13b45c41cd84e9d8a652b74ddba0dd7,
title = "Efficacy of gaze photographs in diagnosing ocular myasthenia gravis",
abstract = "Background and Purpose The various tests that are routinely used to diagnose generalized myasthenia gravis, such as the edrophonium test, serum anti-acetylcholine-receptor antibodies (AChR-Ab), and repetitive nerve stimulation (RNS) tests, have lower diagnostic sensitivity in ocular myasthenia gravis (OMG). Diagnosing OMG becomes even more difficult when the clinical symptoms are subtle. There is no gold-standard diagnostic test available for OMG patients, and so this study compared the diagnostic sensitivity of gaze photographs with conventional tests in OMG. Methods Records of gaze photographs were available for 25 of 31 consecutive patients diagnosed with OMG. Each patient underwent a neuro-ophthalmologic examination, serum AChR-Ab, RNS, edrophonium test, ice tests, and the acquisition of gaze photographs. The margin reflex distance 1 (MRD1) was measured on each of the gaze photographs, with MRD1 <2 mm or an interlid MRD1 difference of ≥2 mm on any of the gaze photographs defined as a positive sign of OMG. The diagnostic sensitivities of the tests were assessed. Results The mean age at onset was 38.5 years (range, 2–76 years), and 13 patients (52{\%}) were men. The diagnostic sensitivities of the RNS test, AChR-Ab test, gaze photographs, and ice test were 56{\%}, 64{\%}, 80{\%}, and 73{\%}, respectively. Conclusions The diagnostic sensitivity was higher for gaze photographs than for the other tests applied to OMG patients.",
keywords = "Diagnosis, Diagnostic sensitivity, Gaze photographs, Ocular myasthenia gravis",
author = "Ahn, {Jee Yun} and Park, {Kyung Seok} and Kim, {Ji Soo} and Jeong-Min Hwang",
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Efficacy of gaze photographs in diagnosing ocular myasthenia gravis. / Ahn, Jee Yun; Park, Kyung Seok; Kim, Ji Soo; Hwang, Jeong-Min.

In: Journal of Clinical Neurology (Korea), Vol. 14, No. 3, 07.2018, p. 333-338.

Research output: Contribution to journalArticle

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AB - Background and Purpose The various tests that are routinely used to diagnose generalized myasthenia gravis, such as the edrophonium test, serum anti-acetylcholine-receptor antibodies (AChR-Ab), and repetitive nerve stimulation (RNS) tests, have lower diagnostic sensitivity in ocular myasthenia gravis (OMG). Diagnosing OMG becomes even more difficult when the clinical symptoms are subtle. There is no gold-standard diagnostic test available for OMG patients, and so this study compared the diagnostic sensitivity of gaze photographs with conventional tests in OMG. Methods Records of gaze photographs were available for 25 of 31 consecutive patients diagnosed with OMG. Each patient underwent a neuro-ophthalmologic examination, serum AChR-Ab, RNS, edrophonium test, ice tests, and the acquisition of gaze photographs. The margin reflex distance 1 (MRD1) was measured on each of the gaze photographs, with MRD1 <2 mm or an interlid MRD1 difference of ≥2 mm on any of the gaze photographs defined as a positive sign of OMG. The diagnostic sensitivities of the tests were assessed. Results The mean age at onset was 38.5 years (range, 2–76 years), and 13 patients (52%) were men. The diagnostic sensitivities of the RNS test, AChR-Ab test, gaze photographs, and ice test were 56%, 64%, 80%, and 73%, respectively. Conclusions The diagnostic sensitivity was higher for gaze photographs than for the other tests applied to OMG patients.

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