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Peribulbar Corticosteroids for Ocular Myasthenia Gravis
Rachel Lasry1, Marc Gotkine, Joshua M Kruger
1Department of Developmental Biology and Cancer Research (RL), The Hebrew University-Hadassah Medical School, Jerusalem, Israel; and Departments of Neurology (MG) and Ophthalmology (JMK), Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Summary
Peribulbar corticosteroids offer an effective treatment for ocular myasthenia gravis, with longer-acting agents like triamcinolone providing sustained symptom relief and reducing injection frequency.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Ocular myasthenia gravis (OMG) is typically managed with oral medications, risking systemic side effects.
- Peribulbar corticosteroid injections present an alternative treatment approach for OMG.
Observation:
- A retrospective chart review examined five patients with OMG treated with peribulbar corticosteroids.
- Four patients had unilateral ophthalmoparesis with ptosis; one had isolated ptosis.
Findings:
- Three of four patients with ptosis and ophthalmoparesis experienced complete symptom resolution within weeks of a single peribulbar injection.
- Symptomatic improvement lasted 5–6 months, with sustained response to repeat injections.
- Peribulbar triamcinolone (40-mg Triesence) demonstrated efficacy, suggesting longer-acting agents are preferable.
Implications:
- Peribulbar corticosteroid injections are a viable and potentially safer treatment for ocular myasthenia gravis.
- Longer-acting corticosteroids, such as triamcinolone, may offer a more convenient and effective treatment regimen, reducing the need for frequent injections.
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