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Abstract Details

Risk of generalization in ocular myasthenia gravis after 10 years.
P6 - Poster Session 6 (12:00 PM-1:00 PM)
 The conversion rate from ocular to generalization was heterogeneous between study range from 15 to 85%. Generalization was a pejorative outcome for OMG without validated preventive strategy 
To assess the proportion of generalization in a cohort of ocular myasthenia gravis (OMG) and determine predictive factors

We design a retrospective observational cohort study of patients ( n = 151) with a  diagnosis of OMG after an initial evaluation made in our institution from Jan 1980 to jan 2017. The outcome mesure was the time to generalization. The explicative variables were age at onset (>54y), sex, AChR status at onset, repetitive stimulation decrement, treatment with steroid before generalization. We proceed to a descritptive analysis of the population, a Kaplan Meyer analysis fitted with Weibull model to calculate the proportion of generalization at 1, 3 and 10 years and a multivariate Cox analysis with Lasso.


151 patients with OMG have been selected and analyzed from 183 identified chart.  The median follow-up was 5.67 y with a total of 1305 patients-years exposition.  AChR test were performed in 143 patients, repetitive stimulation in 124 patients, Enlon test in 69 patients. 

46 patients generalized and the proportion of patients by time who presented a generalization was estimated at 1 year = 11.60% (95CI% 7.89 – 16,74), 3 years = 22,24% (95CI%16.87 – 28.73) and 10 years = 42.25% (95CI%32.86 – 52,24). 

The factors associated with an increased risk of generalization in the multivariate analysis were : 1) Repetitive stimulation +. 2) RACh test +. 3)Sex = women.


The proportion of generalization in our study was in accordance with recent cohort. Prospective observational cohort with a large number of patients seems necessary to overload statistical limitation and identify prognosis factor
Antoine Gueguen, MD (Fondation Oph. A. De Rothschild, Service De Neurologie)
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Olivier F. Gout, MD (Hôpital Fondation A de Rothschild) Dr. Gout has nothing to disclose.