Association Between Serum Anti-Acetylcholine Receptor (AChR-Ab) Titers and Clinical Outcomes in Patients with Ocular-Onset Myasthenia Gravis: An Academic Retrospective Cohort Study
Issued Date
2026-01-01
Resource Type
ISSN
11775467
eISSN
11775483
Scopus ID
2-s2.0-105027740565
Journal Title
Clinical Ophthalmology
Volume
20
Start Page
1
End Page
8
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical Ophthalmology Vol.20 (2026) , 1-8
Suggested Citation
Kemchoknatee P., Pakaymaskul P., Piyawanarat N., Srisombut T. Association Between Serum Anti-Acetylcholine Receptor (AChR-Ab) Titers and Clinical Outcomes in Patients with Ocular-Onset Myasthenia Gravis: An Academic Retrospective Cohort Study. Clinical Ophthalmology Vol.20 (2026) , 1-8. 8. doi:10.2147/OPTH.S570168 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114777
Title
Association Between Serum Anti-Acetylcholine Receptor (AChR-Ab) Titers and Clinical Outcomes in Patients with Ocular-Onset Myasthenia Gravis: An Academic Retrospective Cohort Study
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Corresponding Author(s)
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Abstract
Background: Acetylcholine receptor antibodies (AChR-Ab) are established biomarkers in myasthenia gravis (MG). In ocular MG (OMG), their presence has been linked to disease severity, treatment response, and progression to generalized MG (GMG); however, the relevance of AChR-Ab titers or seropositivity to ocular manifestations remains uncertain. Objective and Method: We retrospectively reviewed OMG patients treated at Rajavithi Hospital (2009–2024). AChR-Ab titers were measured using enzyme-linked immunosorbent assay (ELISA). Clinical and demographic factors associated with AChR-Ab seropositivity (AChR-Ab<sup>+</sup>) and their titers were evaluated using logistic and linear regression analyses. Results: Among the 111 patients with OMG, 51 patients (45.9%) were AChR-Ab<sup>+</sup> and 60 patients (54.1%) were AChR-Ab-seronegative (AChR-Ab<sup>−</sup>). The AChR-Ab<sup>+</sup> group demonstrated a trend toward younger age compared to the AChR-Ab<sup>−</sup> group (43.82 ± 6.55 vs 46.53 ± 7.71 years; p = 0.051). AChR-Ab<sup>+</sup> patients were more likely to present with diplopia, a higher risk of progression to GMG, and more prevalence of thymoma, whereas ptosis was commonly observed in the AChR-Ab<sup>−</sup> group. Gender distribution, autoimmune comorbidities, the use and dosages of pyridostigmine or prednisolones were comparable between groups. Advanced age at onset was associated with lower likelihood of AChR-Ab<sup>+</sup> (OR 0.922; 95% CI: 0.864–0.983, p = 0.014). Diplopia (OR 5.394; 95% CI: 1.280–22.723, p = 0.022), progression to GMG (OR 4.640; 95% CI: 1.155–18.639, p = 0.031), and thymoma (OR 9.978; 95% CI: 2.094–47.547, p = 0.004) were positively associated with AChR-Ab<sup>+</sup> status. Regarding AChR-Ab titers, the presence of thymoma (β =1.556; 95% CI: 0.353–2.761, p = 0.012) was independent predictors, while titers declined with age, most pronounced after 50 years. Conclusion: Serostatus of acetylcholine receptor antibodies may be useful for identifying MG patients at higher risk of generalization or thymoma, while antibody titers may provide complementary information, particularly in relation to thymoma, rather than serving as direct markers of disease severity or ocular manifestations.