ArticleSaudi journal of ophthalmology : official journal of the Saudi Ophthalmological Society
Clinical profile, prognostic factors, and outcomes of rhino-orbital-cerebral mucormycosis in the setting of COVID-19: A retrospective study.
Article in Saudi journal of ophthalmology : official journal of the Saudi Ophthalmological Society. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe purpose was to study the demographics, clinical and radiological presenting patterns, prognostic variables, and outcome of management of rhino-orbital-cerebral-mucormycosis (ROCM) in coronavirus disease (COVID-19) patients.
methodsWe retrospectively analyzed COVID-19 patients with proven ROCM from April 2021 to November 2021. All included patients were given systemic antifungal therapy depending on clinical response and underwent functional endoscopic sinus surgery (FESS) with orbital wall decompression. Administration of transcutaneous retrobulbar amphotericin B (TRAMB) injection, exenteration, and maxillectomy was done when indicated as per a novel algorithm.
resultsA total of 64 patients with ROCM were included in the study. The mean age of 54.5 (standard deviation [SD] - 10.6) years with a male predominance (male: female = 55:9) was observed. Pre-existing diabetes mellitus (DM) was the most common comorbid state, 47 (73.4%). The most common ophthalmic presentation was proptosis (
conclusionROCM has a wide array of presentations, with proptosis as the most common clinical finding. Bulky EOM and intraorbital fat stranding were the most common radiological findings. Thorough surgical debridement with systemic and local antifungal therapy results in reasonable outcomes for ROCM in COVID-19 patients. Older age, intensive care unit admissions, uncontrolled DM, central nervous system involvement, and shorter duration of antifungal treatment are poor prognostic factors associated with mortality.
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