Kanaujiya Reeta, Paruthi Charu, M J Aravind, Sood Komal, Gupta Swarna, Sharma Anuradha
Department of Radiodiagnosis, VMMC & Safdarjung Hospital, New Delhi, 110029, India.
Sharp Sight Eye Hospital, Metro Pillar Number 78, A6/A7, Vikas Marg, Opp. Preet Vihar, Block A, Swasthya Vihar, New Delhi, 110092, India.
Emerg Radiol. 2025 Apr;32(2):217-224. doi: 10.1007/s10140-025-02318-5. Epub 2025 Feb 13.
To illustrate the imaging findings of orbital compartment syndrome (OCS) in patients with orbital mucormycosis and to identify the red flag signs on imaging for prompt diagnosis and timely intervention.
We conducted a retrospective analysis of CT and MRI scans from patients diagnosed with sino-nasal mucormycosis within three months of a confirmed COVID-19 infection. Microbiologically proven cases of mucormycosis were included. Images were analysed for: Route of spread; proptosis; tenting of globe, Retro-orbital fat/extraocular muscle (EOM) nonenhancement; Intra-orbital abscess, superior ophthalmic vein (SOV) thrombosis, stretching/thickening/enhancement/diffusion restriction of optic nerve, orbital coat, and EOM. Descriptive statistics were elaborated in the form of mean/standard deviations for continuous variables and frequencies and percentages for categorical variables.
Out of 138 patients with mucormycosis, 49 had orbital involvement, OCS was present in 16 orbits. The mean age was 48.6 years with M: F of 2.75:1. Adjacent sinuses were involved in all patients. Spread along nerves and nasolacrimal duct was seen in 94% patients. Globe tenting was seen in all and thickening/coat enhancement in 53.3%. Optic nerve (ON) was thickened in 87.5%, diffusion restriction of ON and EOM in 78.5% cases. Non enhancement of retro-orbital fat was seen in 50% and intra-orbital abscess in 62.5% cases.
OCS is a vision-threatening orbital emergency, leading to OIS and permanent blindness, if not managed promptly. Imaging features that warrant immediate clinical/ surgical intervention to avoid permanent loss of vision are distorted globe, posterior tenting of the globe, stretching of the optic nerve, non-enhancement of retro-bulbar fat and extra-ocular muscles (EOMs).
阐述眼眶毛霉菌病患者眼眶间隔综合征（OCS）的影像学表现，并识别影像学上的警示征象，以便及时诊断和干预。
我们对确诊新冠病毒感染后三个月内诊断为鼻窦毛霉菌病患者的CT和MRI扫描进行了回顾性分析。纳入微生物学确诊的毛霉菌病病例。分析图像的以下方面：传播途径；眼球突出；眼球帐篷征；眶后脂肪/眼外肌（EOM）无强化；眶内脓肿、眼上静脉（SOV）血栓形成、视神经、眶壁和眼外肌的拉伸/增厚/强化/扩散受限。连续变量以均值/标准差的形式阐述描述性统计，分类变量以频率和百分比的形式阐述。
在138例毛霉菌病患者中，49例有眼眶受累，16个眼眶存在OCS。平均年龄为48.6岁，男性与女性比例为2.75:1。所有患者均累及相邻鼻窦。94%的患者可见沿神经和鼻泪管传播。所有患者均可见眼球帐篷征，53.3%可见增厚/眶壁强化。87.5%的患者视神经增粗，78.5%的病例视神经和眼外肌有扩散受限。50%的病例可见眶后脂肪无强化，62.5%的病例可见眶内脓肿。
OCS是一种威胁视力的眼眶急症，如果不及时处理，会导致视力损害和永久性失明。需要立即进行临床/手术干预以避免永久性视力丧失的影像学特征是眼球变形、眼球后部帐篷征、视神经拉伸、眶后脂肪和眼外肌（EOM）无强化。
