Ocular manifestations of Rhino-orbital mucormycosis in COVID 19 patients in a tertiary care hospital
Ramapriyadharshini J
, Ilango K , Vijay pradap R , Rajavel MSPS , Maheswaran S
Rhino orbital mucormycosis, covid related mucormycosis , orbital cellulitis, ocular manifestations of mucor, retrobulbar amphotericin,exenteration.
Introduction- Rhino-orbital mucormycosis is a debilitating invasive fungal disease .Mucormycosis is relatively a rare disease affecting only severely immunocompromised patients.This disease has now become a notifiable health disease after covid pandemic leading to mortality and debilitating morbidity .In rhino-orbital cerebral mucormycosis,sinus and nasopharynx are affected first which then rapidly spreads to involve orbit and brain if not treated aggressively at the earliest .The aim of the study is to discuss the various ocular manifestations of mucor and also to highlight the unique features of covid related mucormycosis from endemic mucormycosis. METHODS This is a retrospective review of 50 cases presented in our institute between the period of march 2021 to february 2022. Results: All patients acquired mucor either during covid illness or within 6 weeks of COVID recovery. All patients had poor diabetic control and steroid intake during covid illness as the important predisposing factor. Ocular manifestations in the form of preseptal cellulitis, orbital cellulitis,orbital apex syndrome,central retinal artery occlusion were the common initial presentation. The primary focus of orbital spread is from direct orbital floor erosion from maxillary sinus rather than from ethmoidal sinus highlighting peculiar presentation of covid related mucormycosis from endemic mucor. Conclusion : Covid related mucormycosis has a fulminant course and high mortality risk.Diagnosis during the early stages of covid related mucor is challenging as many patients had atypical initial presentation like central retinal artery occlusion ,proptosis even before nasal symptoms .The unique features of Covid related mucormycosis were very rapid progression to orbit within 2 days and different primary source of orbital spread, directly through orbital floor invasion from maxillary sinus unlike Endemic Mucormycosis. Early diagnosis with high index of suspicion and aggressive surgical and appropriate antifungal treatment can only save the patients from visual morbidity and mortality.
"Ocular manifestations of Rhino-orbital mucormycosis in COVID 19 patients in a tertiary care hospital", IJSDR - International Journal of Scientific Development and Research (www.IJSDR.org), ISSN:2455-2631, Vol.7, Issue 4, page no.210 - 215, April-2022, Available :https://ijsdr.org/papers/IJSDR2204038.pdf
Volume 7
Issue 4,
April-2022
Pages : 210 - 215
Paper Reg. ID: IJSDR_200256
Published Paper Id: IJSDR2204038
Downloads: 000347041
Research Area: Biological Science
Country: Madurai, Tamilnadu, India
ISSN: 2455-2631 | IMPACT FACTOR: 9.15 Calculated By Google Scholar | ESTD YEAR: 2016
An International Scholarly Open Access Journal, Peer-Reviewed, Refereed Journal Impact Factor 9.15 Calculate by Google Scholar and Semantic Scholar | AI-Powered Research Tool, Multidisciplinary, Monthly, Multilanguage Journal Indexing in All Major Database & Metadata, Citation Generator
Publisher: IJSDR(IJ Publication) Janvi Wave
