Autoimmune retinopathy in patients with myasthenia gravis: cases series and literature review.

Yiqiao Chen, Yexin Zhang, Jia Luo, Miaomiao Liu, Min Lin, Wenhua Zhu, Wenjun Xiong, Peiquan Zhao, Jianying Xi, Ping Fei

Journal: BMC ophthalmology 2025;25(1):521

PMID: 41029312

Abstract

BACKGROUND

Previous studies showed a higher frequency of concurrent autoimmune disease (AD) in patients with Myasthenia gravis (MG), but very few cases on MG patients complicated with AIR have been reported in preview literature. The goal of this study was to present three cases of autoimmune retinopathy (AIR) with myasthenia gravis (MG), conduct a literature search, and summarize the clinical characteristics of this entity.

METHODS

Case series and literature review.

RESULTS

The seven AIR patients with MG were six females and a male with a mean age of 41.29(± 15.22)years old. Five had thymoma, and two had no tumor. Their symptoms of MG improved after treatment. The main ocular manifestations of AIR were bilateral, subacute, painless vision loss. The fundus examinations showed diffuse pigmentary retinopathy and atrophy of retina. Electroretinography (ERG) showed dysfunction of rod and cone cell. Hereditary retinopathy was ruled out. ARA (anti-retinal antibody) testing showed positive result for anti-retinal antibodies (ARAs), confirming the diagnosis of AIR.

CONCLUSIONS

There is a certain frequency of concurrent MG and AIR. Patients with AIR have distinct features in the course of the disease, multimodal auxiliary examination and ARA testing. Suspected cases of MG should be comprehensively screened for early diagnosis and treatment of AIR.

Address: Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.; Department of Neurology, Huashan Hospital Affiliated to Fudan University, Shanghai, China.; Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China.; Department of Neurology, Huashan Hospital Affiliated to Fudan University, Shanghai, China. [email protected].; Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [email protected].

DOI: 10.1186/s12886-025-04357-5

MeSH Terms: Humans, Myasthenia Gravis, Male, Female, Adult, Middle Aged, Autoimmune Diseases, Retinal Diseases, Electroretinography, Autoantibodies