Department of Ophthalmology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.
Indian J Ophthalmol. 2022 Dec;70(12):4451-4453. doi: 10.4103/ijo.IJO_1318_22.
Mucormycosis is a serious, rapidly progressing, life-threatening, and sight threatening fungal infection frequently seen in diabetics and immunocompromised patients. We report a rare occurrence of rhino-orbital mucormycosis presenting as unilateral central retinal vein occlusion (CRVO) and no other ocular signs of infection in a 65-year-old diabetic male. The definitive diagnosis was made by nasal biopsy which confirmed broad branching aseptate fungal hyphae. The patient was treated with amphotericin B for mucormycosis and intravitreal anti-vascular growth factor (anti-VEGF) drug for macular edema. To conclude, although ophthalmoplegia is the most common ocular presentation and retinal artery occlusion is the most common cause of visual loss in mucormycosis, it may have many varied presentations including CRVO. A high index of suspicion must be kept in diabetics and immunocompromised patients.
毛霉菌病是一种严重的、迅速进展的、危及生命的、威胁视力的真菌感染,常见于糖尿病患者和免疫功能低下者。我们报告了一例罕见的发生于 65 岁糖尿病男性的单侧中央视网膜静脉阻塞(CRVO)和无其他眼部感染体征的鼻眶脑毛霉菌病。鼻活检明确了广泛分支的无隔真菌菌丝,做出了明确诊断。该患者接受两性霉素 B 治疗毛霉菌病和玻璃体内抗血管生成因子(抗 VEGF)药物治疗黄斑水肿。总之,尽管眼肌麻痹是最常见的眼部表现,视网膜动脉阻塞是毛霉菌病导致视力丧失的最常见原因,但它可能有多种表现形式,包括 CRVO。糖尿病患者和免疫功能低下者必须保持高度怀疑。