{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:27:57Z","timestamp":1787185677850,"version":"build-2736575974"},"reference-count":34,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["canadianjournalofophthalmology.ca","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Canadian Journal of Ophthalmology"],"published-print":{"date-parts":[[2026,8]]},"DOI":"10.1016\/j.jcjo.2026.01.018","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T12:48:05Z","timestamp":1770900485000},"page":"967-972","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and clinical characteristics of concurrent thyroid eye disease and ocular myasthenia gravis"],"prefix":"10.1016","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1804-9526","authenticated-orcid":false,"given":"Muhammad","family":"Abumanhal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chrisha Faye","family":"Habaluyas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Umezawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1363-2870","authenticated-orcid":false,"given":"Yasuhiro","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jcjo.2026.01.018_bib0001","doi-asserted-by":"crossref","first-page":"48","DOI":"10.3390\/antib12030048","article-title":"The usefulness of thyroid antibodies in the diagnostic approach to autoimmune thyroid disease","volume":"12","author":"Vargas-Uricoechea","year":"2023","journal-title":"Antibodies (Basel)"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0002","doi-asserted-by":"crossref","first-page":"212","DOI":"10.3389\/fimmu.2020.00212","article-title":"Autoantibody specificities in myasthenia gravis: implications for improved diagnostics and therapeutics","volume":"11","author":"Lazaridis","year":"2020","journal-title":"Front Immunol"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0003","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1089\/thy.2000.10.799","article-title":"Increased frequency of euthyroid ophthalmopathy in patients with Graves\u2019 disease associated with myasthenia gravis","volume":"10","author":"Marin\u00f2","year":"2000","journal-title":"Thyroid"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0004","first-page":"63","article-title":"Clinical significance of autoimmune thyroid disease in myasthenia grabis","volume":"108","author":"Weissel","year":"2000","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0005","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1111\/j.1365-2249.1995.tb03674.x","article-title":"Antibodies to acetylcholinesterase cross-reacting with thyroglobulin in myasthenia gravis and Graves's disease","volume":"100","author":"Mappouras","year":"1995","journal-title":"Clin Exp Immunol"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0006","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1097\/00041327-199509000-00008","article-title":"Acetylcholine receptor antibodies in patients with Graves\u2019 ophthalmopathy","volume":"15","author":"Jacobson","year":"1995","journal-title":"J Neuroophthalmol"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0007","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1111\/j.1600-0404.2012.01693.x","article-title":"Clinical features of myasthenia gravis patients with autoimmune thyroid disease in Taiwan","volume":"127","author":"Chen","year":"2013","journal-title":"Acta Neurol Scand"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0008","first-page":"377","article-title":"Graves' ophthalmopathy, ocular myasthenia gravis and Hashimoto\u2019s thyroiditis","volume":"21","author":"Czernobilsky","year":"1985","journal-title":"Isr J Med Sci"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0009","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1186\/s12886-020-01431-y","article-title":"Histopathologic study of extraocular muscles in thyroid-associated ophthalmopathy coexisting with ocular myasthenia gravis: a case report","volume":"20","author":"Ma","year":"2020","journal-title":"BMC Ophthalmol"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0010","doi-asserted-by":"crossref","first-page":"5909","DOI":"10.1007\/s10072-024-07728-w","article-title":"Clinical characteristics and therapeutic effect of myasthenia gravis coexisting with thyroid eye disease","volume":"45","author":"Chen","year":"2024","journal-title":"Neurol Sci"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0011","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1002\/mus.27118","article-title":"Challenges in diagnosing coexisting ocular myasthenia gravis and thyroid eye disease","volume":"63","author":"Claytor","year":"2021","journal-title":"Muscle Nerve"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0012","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1016\/j.jocn.2007.09.028","article-title":"Concurrent presentation of ocular myasthenia and euthyroid Graves ophthalmopathy: a diagnostic challenge","volume":"15","author":"Zouvelou","year":"2008","journal-title":"J Clin Neurosci"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0013","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.survophthal.2007.04.005","article-title":"Double vision in a patient with thyroid eye disease: what\u2019s the big deal?","volume":"52","author":"Chen","year":"2007","journal-title":"Surv Ophthalmol"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0014","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1016\/S0002-9394(14)72787-4","article-title":"Diagnostic criteria for Graves' ophthalmopathy","volume":"119","author":"Bartley","year":"1995","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0015","series-title":"Myasthenia gravis (designated intractable disease 11): overview and diagnostic criteria established by Ministry of Health","year":"2024"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0016","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1212\/WNL.0000000000002790","article-title":"International consensus guidance for management of myasthenia gravis: executive summary","volume":"87","author":"Sanders","year":"2016","journal-title":"Neurology"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0017","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1136\/bjo.73.8.639","article-title":"Clinical criteria for the assessment of disease activity in Graves' ophthalmopathy: a novel approach","volume":"73","author":"Mourits","year":"1989","journal-title":"Br J Ophthalmol"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0018","author":"Phelps"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0019","series-title":"Ptosis","author":"Shahzad","year":"2023"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0020","doi-asserted-by":"crossref","first-page":"91","DOI":"10.2174\/1874364101004010091","article-title":"Frontalis suspension surgery in upper eyelid blepharoptosis","volume":"4","author":"Takahashi","year":"2010","journal-title":"Open Ophthalmol J"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0021","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1097\/WNO.0000000000001425","article-title":"Interobserver and intra-observer reliability of eyelid tests for ocular myasthenia gravis","volume":"42","author":"Jienmaneechotchai","year":"2022","journal-title":"J Neuroophthalmol"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0022","author":"Nair"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0023","author":"Suresh"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0024","series-title":"The Japanese Committee for Diagnostic Criteria and Guideline to Medical Care for Thyroid-Associated Malignant Exophthalmos","year":"2018"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0025","doi-asserted-by":"crossref","DOI":"10.1007\/s11606-024-09120-y","article-title":"Hickam\u2019s dictum: an analysis of multiple diagnoses","author":"Aberegg","year":"2024","journal-title":"J Gen Intern Med"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0026","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1097\/WCO.0000000000001339","article-title":"Thyroid eye disease and ocular myasthenia gravis","volume":"38","author":"Shabto","year":"2025","journal-title":"Curr Opin Neurol"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0027","doi-asserted-by":"crossref","DOI":"10.1016\/j.autrev.2019.102368","article-title":"Thyroid disorders in patients with myasthenia gravis: A systematic review and meta-analysis","volume":"18","author":"Song","year":"2019","journal-title":"Autoimmun Rev"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0028","doi-asserted-by":"crossref","first-page":"12","DOI":"10.4103\/tjo.tjo_57_21","article-title":"Management of eyelid retraction related to thyroid eye disease","volume":"12","author":"Osaki","year":"2022","journal-title":"Taiwan J Ophthalmol"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0029","series-title":"Practical management of pediatric ocular disorders and strabismus","first-page":"559","article-title":"Management of strabismus in thyroid eye disease","author":"Traboulsi","year":"2016"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0030","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2022.1030422","article-title":"Long-term follow-up of surgical treatment of thyroid-associated orbitopathy restrictive strabismus","volume":"13","author":"Savino","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0031","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1007\/s10384-025-01208-0","article-title":"Clinical study of thyroid eye disease combined with myasthenia gravis","volume":"69","author":"Wu","year":"2025","journal-title":"Jpn J Ophthalmol"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0032","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2024.1353248","article-title":"Investigation of the differential susceptibility of extraocular muscles in patients diagnosed with ocular myasthenia gravis based on the computerized diplopia test and the Ocular Motor Nerve Palsy Scale","volume":"15","author":"Fan","year":"2024","journal-title":"Front Neurol"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0033","article-title":"Ophthalmologic clinical features of ocular myasthenia gravis","volume":"102","author":"Kim","year":"2023","journal-title":"Medicine (Baltimore)"},{"key":"10.1016\/j.jcjo.2026.01.018_bib0034","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1111\/ene.12359","article-title":"EFNS\/ENS Guidelines for the treatment of ocular myasthenia","volume":"21","author":"Kerty","year":"2014","journal-title":"Eur J Neurol"}],"container-title":["Canadian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0008418226000207?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0008418226000207?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:20:58Z","timestamp":1787185258000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0008418226000207"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":34,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["S0008418226000207"],"URL":"https:\/\/doi.org\/10.1016\/j.jcjo.2026.01.018","relation":{},"ISSN":["0008-4182"],"issn-type":[{"value":"0008-4182","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Incidence and clinical characteristics of concurrent thyroid eye disease and ocular myasthenia gravis","name":"articletitle","label":"Article Title"},{"value":"Canadian Journal of Ophthalmology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jcjo.2026.01.018","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}