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Outcomes and factors affecting them in patients with rhino-orbito-cerebral mucormycosis
  1. Mohsen Bahmani Kashkouli,
  2. Parya Abdolalizadeh,
  3. Mitra Oghazian,
  4. Yasaman Hadi,
  5. Nasser Karimi,
  6. Mahya Ghazizadeh
  1. Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
  1. Correspondence to Professor Mohsen Bahmani Kashkouli, Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran 1455364, Iran; mkashkouli2{at}gmail.com

Abstract

Aim To report the frequency and factors affecting patients’, globe and vision survivals in rhino-orbito-cerebral mucormycosis (ROCM).

Methods This is a retrospective study of 63 patients (79 eyes) with biopsy-proven ROCM at a university hospital 2008–2016. Systemic and ophthalmic manifestations, imaging, management and final outcomes were recorded. Globe survival was defined as no exenteration and vision survival as final visual acuity of light perception and more.

Results Mean age was 55.5 (SD 12.9) years with no gender preference. Diabetes was the most common underlying disease (68.3%). Patient survival was observed in 57.1 % (36/63). Presence of frozen eye (OR 4.6), nasal mucosal involvement (OR 7.3) and shorter duration of antifungal therapy (OR 1.03) were significantly associated with lower patient survival. Exenteration did not significantly change the survival. Globe survival was detected in 43% (34/79). Higher white blood cell (WBC) count was associated with a lower globe survival (p=0.02). Vision survival was observed in 25.3% (20/79) in whom younger age was significantly associated with a worse vision survival.

Conclusion Patient, globe and vision survivals were 57%, 43% and 25%, respectively. Exenteration did not affect the patients’ survival. While frozen eye and nasal mucosal involvement were significantly associated with a lower survival, higher WBC count significantly increased the risk of exenteration.

  • mucormycosis
  • orbital infection
  • rhino-orbito-cerebral mucormycosis
  • patients survival
  • globe survival
  • vision survival

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Footnotes

  • Contributors Conception or design of the work: MBK. Data collection: MO, YH, MG. Data analysis and interpretation: PA, NK. Drafting the article: PA, MBK. Critical revision of the article: MBK, NK. Final approval of the version to be published: MBK, PA, MO, YH, NK, MG.

  • Funding This study was funded by Iran University Eye Research Center (IR.IUMS.REC 1394.26261).

  • Disclaimer Iran University Eye Research Center had no role in design, collection, interpretation, analysis, execution of the study and decision to submit the paper for publication.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Iran University Eye Research Center.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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