{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T10:35:59Z","timestamp":1782902159885,"version":"3.54.5"},"reference-count":13,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T00:00:00Z","timestamp":1685491200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["pericles.pericles-gcp.literatumonline.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Most patients with myasthenia gravis (MG) develop ocular manifestations during their illness and up to 22% may have isolated ocular myasthenia gravis (OMG). Apraclonidine elevates the eyelid by activating alpha\u20102 receptors on Muller's muscle, an accessory eyelid elevator muscle. In this study we evaluate the effect of apraclonidine in alleviating ptosis secondary to MG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This clinical trial (NCT05045248) was done at the American University of Beirut Medical Center. Patients with ptosis secondary to MG were administered two drops of apraclonidine 0.5% solution to the most affected eye. We measured palpebral fissure height (PF), marginal reflex distance\u20101 (MRD1), marginal reflex distance\u20102 (MRD2), and levator function (LF) before drug administration and at 1, 5, 30, and 60 minutes after administration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten participants were enrolled in the study. Improvement in all eyelid measurements was noted in all participants as early as 1\u2009minute after apraclonidine administration. From baseline to 60\u2009minutes after administration, average PF increased from 8.8\u2009\u00b1\u20091.9\u2009mm to 14.2\u2009\u00b1\u20092.6\u2009mm, MRD\u20101 from 1.7\u2009\u00b1\u20091.4\u2009mm to 5.4\u2009\u00b1\u20092.9\u2009mm, MRD\u20102 from 7.1\u2009\u00b1\u20091.3\u2009mm to 8.8\u2009\u00b1\u20091.7\u2009mm, and LF from 13.4\u2009\u00b1\u20092.9\u2009mm to 17.5\u2009\u00b1\u20092.4\u2009mm. All increases were statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Apraclonidine may alleviate ptosis secondary to MG and may be an effective alternative treatment for this group of patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27851","type":"journal-article","created":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T06:51:00Z","timestamp":1685602260000},"page":"206-210","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Efficacy of apraclonidine eye drops in treating ptosis secondary to myasthenia gravis: A pilot clinical trial"],"prefix":"10.1002","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7975-2277","authenticated-orcid":false,"given":"Mohamad","family":"Agha","sequence":"first","affiliation":[{"name":"Department of Neurology American University of Beirut Medical Center  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0211-1834","authenticated-orcid":false,"given":"Helen","family":"Ismail","sequence":"additional","affiliation":[{"name":"Department of Neurology American University of Beirut Medical Center  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja","family":"Sawaya","sequence":"additional","affiliation":[{"name":"Department of Neurology American University of Beirut Medical Center  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnny","family":"Salameh","sequence":"additional","affiliation":[{"name":"Department of Neurology American University of Beirut Medical Center  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70063-8"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27120"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/IOP.0000000000001095"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1602678"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2017.03.025"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNO.0b013e31821a91fe"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.73.11.884"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2006.04.052"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.79.12.1098"},{"key":"e_1_2_11_11_1","unstructured":"KlejchW VisliselJM AllenRC.A primer on ptosis. Accessed January 14 2019.http:\/\/www.eyerounds.org\/tutorials\/ptosis"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/IOP.0b013e31817f526a"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/IOP.0000000000000843"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-14-142"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.27851","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T12:19:17Z","timestamp":1693916357000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.27851"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,31]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1002\/mus.27851"],"URL":"https:\/\/doi.org\/10.1002\/mus.27851","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,31]]},"assertion":[{"value":"2022-11-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}