Ocular Findings in Children with Ocular Myasthenia Gravis.

Kim, Jong Hyun; Hwang, Jeong Min; Hwang, Yong Seung; Kim, Ki Joong; Chae, Jonghee

Original Article

Journal of the Korean Ophthalmological Society 2002;43(4):707-713.
Published online April 1, 2002.

Ocular Findings in Children with Ocular Myasthenia Gravis.

Jong Hyun Kim, Jeong Min Hwang, Yong Seung Hwang, Ki Joong Kim, Jonghee Chae

¹Department of Ophthalmology, Seoul National University College of Medicine, Korea.
²Department of Ophthalmology, Seoul Municipal Boramae Hospital, Korea. hjm@snu.ac.kr
³Department of Pediatrics, Seoul National University College of Medicine, Korea.

안근무력증 어린이의 눈 소견

김종현 ( Jong Hyun Kim ) , 황정민 ( Jeong Min Hwang ) , 황용승 ( Yong Seung Hwang ) , 김기중 ( Ki Joong Kim ) , 채종희 ( Jong Hee Chae )

Abstract

PURPOSE
In order to make an accurate diagnosis, we investigated clinical manifestations and ocular findings in children with ocular myasthenia gravis that can be easily misdiagnosed. METHODS: The medical records of 7 boys and 18 girls under the age of 15 years with ocular myasthenia gravis were reviewed retrospectively. The mean follow-up period was 37 months. RESULTS: The mean age at onset was 37 months. Ptosis was found in 22 patients(88%), strabismus in 21 patients(84%) and amblyopia in 5 patients(20%). Exotropia combined with vertical heterotropia was the most frequent type of strabismus. Ocular motility abnormality was found in 17 patients(68%). The limitation of supraduction or infraduction was most frequently observed. The manifestations of strabismus and ocular motility abnormality were variable and frequently changed during follow-up period. Prednisolone was used more often than pyridostigmine as a maintenance therapy. Ptosis was more responsive to drug therapy than strabismus. CONCLUSIONS: The main ocular findings in ocular myasthenic children were ptosis and exotropia that was not commonly found in Caucasian children. Vertical heterotropia as well as ptosis were commonly accompanied with the horizontal heterotropia. The type and angle of strabismus as well as ocular motility in duction/version were variable during follow-up period

Key Words: Children;Ocular myasthenia gravis;Ocular motility abnormality;Ptosis;Strabismus