The ophthalmologic characteristics in pediatric myasthenia gravis.

Sasaki Yuko, Kobayashi Junko, Kambe Tomoka, Hamano Shinichiro

doi:10.4263/jorthoptic.045f120

[Purpose] To investigate the ophthalmologic characteristics of pediatric myasthenia gravis (MG).[Methods] Fifteen children with pediatric MG (6 males, 9 females) who visited the outpatient clinic of either the ophthalmology or neurology department of Saitama Children's Medical Center in Saitama, Japan between 2010 and 2014 were retrospectively reviewed. Mean age at onset was 5.6 years (range, 0.9-13.9 years). Data abstracted from the medical records were analyzed, including age at onset, clinical type of MG, previously consulted medical services, initial symptoms, chief complaints, clinical findings at first clinic visit such as presence of ptosis, ocular alignment, ocular duction, and amblyopia.[Results] Of 15 children with pediatric MG, 10 showed onset before 5 years old. Classification types were divided into two groups: ocular MG in 11 children and generalized MG in 4. Ten patients initially consulted with ophthalmology clinics. Ptosis was both the most common chief complaint and the most common initial eye finding. All cases showed ptosis, and 9 had strabismus with exotropia in 6 cases. Ocular movement limitation was seen in 12 cases. Three cases developed amblyopia, of which 2 were attributed to MG and the other to ametropia. Amblyopia treatment with patching and glasses succeeded in all 3 patients.[Conclusion] Early detection could allow treatment of amblyopia from pediatric MG. As various ocular findings with pediatric MG may also be present at the initial consultation, we need to recognize the importance of obtaining a thorough medical history and careful observation of daily behaviors by parents to achieve a clear diagnosis.

The ophthalmologic characteristics in pediatric myasthenia gravis.

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