Journal d'ophtalmologie clinique et expérimentale
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Clinical Study and Outcome of Rhino-Orbital Mucormycosis Patients

Swati Sonwalkar*

Objectives: To know the clinical presentation and outcome of rhino-orbital-cerebral mucormycosis during the limited availability of facilities during the acute surge of COVID 19 pandemic.

Method: we conducted a retrospective, non-interventional observational study on 55 patients with rhino-orbitalcerebral mucormycosis. The study was undertaken based on the data available from case records that were diagnosed with Rhino-Orbital mucormycosis.

Results: The mean age was 51.1 ± 11.3 years with a male preponderance of 72.7%. 50% of patients were receiving treatment in mucormycosis ward. Concurrent on going COVID-19 with ROCM and past history of COVID-19 was present in 49.1% and 34.5% respectively. History of steroid usage was seen in 81.81% of cases. Old case of diabetes and newly diagnosed diabetics were 47.3% and 32.7% respectively. The most common clinical presentation was proptosis (65.5%), partial ophthalmoplegia (65.6%) and ptosis (50.9%), with highest number of patients involving orbital apex (34%). Injection amphotericin B, TRAMB, FESS, FESS with orbital debridement and exoneration was done in 76.4%, 74.5%, 72.7%, 32.4% and 1.8% respectively.

Conclusion: Mucormycosis should be suspected in patients with COVID-19 irrespective of severity with history of steroid usage associated with diabetes mellitus in second and third week. Our study signifies the importance of early diagnosis and prompt initiation of treatment with systemic, transcutaneous retrobulbar amphotericin B injection and debridement of the orbit helps to salvage eye without requiring orbital exenteration. Even during scarcity of drugs and inadequately equipped health system we were still able to salvage eyes in maximum number of patients.