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 of thediagnoses (1) and (2)-(5): (1) The patient's symptoms involve the extraocular muscles,except for drooping eyelids and diplopia, no other clinical symptoms; (2) unequivocalclinical response to pyridostigmine; (3) positive acetylcholine receptor antibody ormusk antibody; (4) decrement of more than 10% in repetitive nerve stimulations study (RNS); (5) the "trembling" of the single fiber electromyography (SFEMG) is broadenedwith or without blockade;
3. Willingness to sample collection, imaging study and other disease-related examinationsand assessments;
4. The results of pregnancy tests for female subjects with fertility during the screeningperiod should be negative and effective contraception was used by the patient and herspouse 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 due toother 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 to severemental 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.