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首页> 外文期刊>Journal of neurology >Generalization of ocular myasthenia gravis 10?years after onset
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Generalization of ocular myasthenia gravis 10?years after onset

机译：Generalization of ocular myasthenia gravis 10?years after onset

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Abstract Background Generalization of ocular myasthenia gravis (OMG) represents a pejorative evolution, and no validated generalization-prevention strategy exists. The study aimed to determine the percentage of patients with OMG generalization and identify factors predictive of it to establish a prediction score.Methods This retrospective, observational study included 151 patients diagnosed with OMG after an initial work-up in our institution. The outcome measure was time to MG generalization. The explanatory variables were age at onset (>?55?years), sex, first-year anti-acetylcholine-receptor antibody-positivity, repetitive nerve stimulation showing electromyogram decrement and corticosteroid use. Kaplan–Meier estimations of the probability of risk of generalization, and descriptive and multivariate Cox model analyses were computed. A nomogram combining explanatory variables was used to establish a score to predict the probability of OMG generalization.Results Among 183 patients’ charts identified, 151 had confirmed OMG. Their median follow-up was 5.7?years. Estimations (95% CI) of OMG-generalization risk at 1, 3 and 10?years post-symptom onset, respectively, were: 13.0% (7.3–18.2), 25.1% (17.5–32.0) and 37.8% (27.2–45.2). The p-value-based multivariate analysis associated generalization with female sex, electromyogram decrement and first-year anti-acetylcholine-receptor antibody positivity, and Akaike information criterion-based analysis retained those three parameters and corticosteroid use. A nomogram was built and validated with an optimism-corrected C-statistic of 0.68, and calibration plots showed good fit.Conclusions Our population’s percentage of OMG generalization is in line with recent publications. Using the identified prognostic factors, the nomogram provided a score to predict the probable risk of generalization in our cohort.

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