FIGURE 1 - available via license: Creative Commons Attribution 3.0 Unported
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Pictures demonstrate the presence of baseline bilateral eyelid ptosis in image A, and the improvement of ptosis 30 mins after instillation of oxymetazoline hydrochloride 0.1% ophthalmic solution in image B.
Source publication
In this article, we described two patients with myasthenia gravis-related ptosis who experienced sustained improvement with the use of oxymetazoline hydrochloride ophthalmic solution 0.1%. Despite the commonly used treatments for ptosis in myasthenia gravis (MG), such as acetylcholinesterase inhibitors and corticosteroids, complete remission of pto...
Context in source publication
Context 1
... oxymetazoline hydrochloride 0.1% ophthalmic solution was helpful in alleviating ptosis in addition to the above treatment. Improvement of ptosis occurred within 30 minutes of each application to the eye and lasted for an average of six to eight hours ( Figure 1). On average, a dosage of once daily was sufficient, and the patient found it particularly helpful when used prior to vision-intensive activities such as driving. ...
Citations
... Despite the prevalence of ocular myasthenia gravis (MG), literature on the acute treatment of these symptoms is sparse [1][2][3]. MG is an autoimmune disorder characterized by autoantibodies against postsynaptic acetylcholine receptors at neuromuscular junctions (NMJ) [4][5][6]. Ptosis is a classic symptom of MG and a significant cause of morbidity in patients [2][3][4]. ...
... MG is an autoimmune disorder characterized by autoantibodies against postsynaptic acetylcholine receptors at neuromuscular junctions (NMJ) [4][5][6]. Ptosis is a classic symptom of MG and a significant cause of morbidity in patients [2][3][4]. In MG patients, ptosis is characterized by downward displacement of the upper eyelids that progressively worsens throughout the day [2,6]. ...
... Ptosis is a classic symptom of MG and a significant cause of morbidity in patients [2][3][4]. In MG patients, ptosis is characterized by downward displacement of the upper eyelids that progressively worsens throughout the day [2,6]. Ptosis is the initial presenting symptom in over half of patients with MG and is eventually present in over 90% of patients with the condition [6]. ...
The current pharmaceutical management of myasthenia gravis (MG) is widely accepted to be pyridostigmine and prednisone, both known to cause adverse effects and incur significant costs. This treatment may be particularly burdensome for patients primarily complaining of localized ocular MG, and little is known about the management of MG ptosis with topical medications. Oxymetazoline hydrochloride 0.1% ophthalmic solution has recently been approved by the FDA for the treatment of ptosis, but there have been limited studies in MG ptosis and no report to date of symptomatic improvement with the intranasal formulation. This case report discusses a 71-year-old female whose newly diagnosed MG ptosis resolved after three days of intranasal oxymetazoline hydrochloride 0.05%, followed by three days of intranasal flunisolide. Our patient’s rapid resolution of symptoms, along with the favorable side effect profile and over-the-counter availability, highlights the promising indication for the use of intranasal oxymetazoline and flunisolide as potential alternatives or adjuncts in MG management. Further research in larger cohorts is necessary to confirm the efficacy of these nasal sprays in treating MG ptosis.
