Institutional members access full text with Ovid®

Share this article on:

Extraocular Muscle Findings in Myasthenia Gravis Associated Treatment-Resistant Ophthalmoplegia: A Case Report.

Rautenbach, Robyn M. MSc; Pillay, Komala MBChB; Murray, Anthony D. N. MBChB; Heckmann, Jeannine M. PhD
Journal of Neuro-Ophthalmology: Post Author Corrections: July 24, 2017
doi: 10.1097/WNO.0000000000000534
Clinical Observation: PDF Only

We report the histopathological and ultrastructural tissue analysis of extraocular muscle (EOM) obtained from a patient with seronegative myasthenia gravis (MG) with treatment-resistant ophthalmoplegia for 3.5 years. The EOM demonstrated predominantly myopathic features and ultrastructural evidence of mitochondrial dysfunction, but the most striking features were increased endomysial collagen and adipocyte replacement of muscle fibers. By contrast, control EOM from a patient undergoing strabismus surgery for a sensory exotropia in a nonseeing eye and a similar duration of deviation, showed normal muscle histology. Although the histopathological and ultrastructural findings largely resemble those of limb muscle in MG, the abundant endomysial collagen may be nonspecific and secondary to poor force generation as a result of chronic ophthalmoplegia.

(C) 2017 by North American Neuro-Ophthalmology Society