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KMID : 1036520120020020103
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Clinical Neuro-Ophthalmology
2012 Volume.2 No. 2 p.103 ~ p.105
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Ocular Myasthenia Gravis Associated with Thyroid Ophthalmopathy
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Choi Jae-Hwan
Kim Hyun-Woo
Lee Seung-Han
Choi Kwang-Dong
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Abstract
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Ocular myasthenia gravis (MG) and thyroid ophthalmopathy (TO) are common autoimmune disorders causing ophthalmoplegia and diplopia. Overlapping clinical features may lead to diagnostic confusion when ocular MG and TO coexist. A 44-year-old man with previous hyperthyroidism presented with fluctuating diplopia and ptosis for 2 years. Examination revealed bilateral exophthalmos and ophthalmoplegia, and a fluctuating ptosis in the right eye. Serum acetylcholine receptor antibody and thyroid peroxidase antibody titer were elevated, and orbit MRI disclosed thickening of the left medial rectus muscle. After oral pyridostigmine in combination with systemic steroid treatment, ptosis and diplopia makedly improved. In patients with ocular MG or TO, coexistence of both diseases should be considered since the dual therapy of both diseases will prevent irreversible damage of the extraocular muscle and optic nerve function or occurrence of the myasthenic crisis.
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KEYWORD
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Ocular myasthenia gravis, Thyroid ophthalmopathy, Graves’ disease
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