TheRapeutic Effect of Different immunosuppressAnts on Non-Thymoma Ocular Myasthenia Gravis: a Real-world Study

Inclusion Criteria:

1. Age >18 years and<75 years;

2. Clinical Diagnosis of MG with supporting evidence: Patients with ocular muscle type MG who have never received treatment meet one ofthe diagnoses (1) and (2)-(5): (1) The patient's symptoms involve the extraocularmuscles, except for drooping eyelids and diplopia, no other clinical symptoms; (2)unequivocal clinical response to pyridostigmine; (3) positive acetylcholine receptorantibody or musk antibody; (4) decrement of more than 10% in repetitive nervestimulations study (RNS); (5) the "trembling" of the single fiber electromyography (SFEMG) is broadened with or without blockade;

3. Willingness to sample collection, imaging study and other disease-relatedexaminations and assessments;

4. The results of pregnancy tests for female subjects with fertility during thescreening period should be negative and effective contraception was used by thepatient and her spouse during the study period;

5. Patients with informed consent;

6. Predicted survival time is longer than 3 years.

Exclusion Criteria:

1. History of chronic degenerative, psychiatric, or neurologic disorder other than MGthat can produce weakness or fatigue;

2. Patients who may have other diseases that may lead to eyelid drooping, peripheralmuscle weakness or diplopia;

3. Age ≤18 years or ≥75 years;

4. Patients who have been taking glucocorticoids or associated immunosuppressants dueto other immune system diseases;

5. Patients who cannot use immunosuppressants due to other chronic diseases;

6. Patients who are unable to cooperate with follow-up and self-assessment due tosevere mental illness or cognitive impairment;

7. Pregnant women, lactating women and patients with fertility plans during the trial;

8. Patients who have suffered from severe infections or malignant tumors in the last 1month and are unable to receive immunosuppressants treatments;

9. Patients who are not willing to cooperate with repeated frequency electricalstimulation tests and chest CT examinations;

10. Patients who are not willing to participate in this study;

11. Patients who are unable to sign informed consent;

12. Predicted survival time is shorter than 3 years;

13. Patients who are not suitable to participated in the trial after researchers'assessment.