A retrospective study of acetylcholine receptor antibody positive ocular myasthenia in the West of Scotland.

Ocular myasthenia is the milder end of the myasthenia gravis spectrum but treatment can be challenging especially in older patients. We retrospectively studied all patients on our database with ocular myasthenia (OMG), positive for acetylcholine receptor (AChR) antibodies. We identified 93 patients (64 men and 29 women). The mean age at disease onset was 63y, median 68y. Most (72%) experienced ptosis with diplopia; 19% experienced ptosis alone, while 7.5% complained of diplopia without ptosis. As expected, pyridostigmine was commenced early at diagnosis in the majority (69%) and 20% were still receiving pyridostigmine at final review. Immunosuppression was prescribed in 50%. Seven patients had ptosis repair surgery; 20 patients used prisms at some stage. >75% had several comorbidities. Our OMG cohort is an older population with several comorbidities. Final outcomes in those who received immunosuppression were similar to those who had not.