Challenges and Pitfalls in the Management of Rhino-Orbital Mucormycosis in Ophthalmology: A Highlighted Problem in the COVID-19 Era

Pakdel, Farzad; Zand, Amin; Sharifi, Ali; Asadi, Masih; Aghdam, Kaveh Abri

doi:10.18502/jovr.v17i3.11582

Cited by 3 publications

(2 citation statements)

References 44 publications

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“…Its use in poorly controlled diabetics may also contribute to the high rates of mucormycosis. [ 13 , 32 ]…”

Section: Discussionmentioning

confidence: 99%

Oculoplastic Conditions in Covid-19 Patients: Case Series and Literature Review

Yvon,

Patel,

et al. 2024

JOVR

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Purpose: To investigate oculoplastic conditions in patients diagnosed with coronavirus disease 2019 (COVID-19) seen at ophthalmology departments of three tertiary referral centers in the United Kingdom and the United States, and review of the literature. Methods: Retrospective multicenter case series studied over 18 months. Results: A total of four patients developed eyelid, orbital, or lacrimal gland pathology within four weeks of testing positive for COVID-19. All were male, and the mean age at presentation was 49 (range, 31–58 years). Suspected diagnoses included anterior idiopathic orbital inflammation, facial angioedema, dacryoadenitis, and anophthalmic socket inflammation. Three patients recovered fully and one patient recovered partially (mean 2.7 weeks) from ocular manifestations with steroids hastening recovery. Conclusion: Adnexal manifestations of COVID-19 include self-limiting orbital inflammation and eyelid lymphedema.

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“…Its use in poorly controlled diabetics may also contribute to the high rates of mucormycosis. [ 13 , 32 ]…”

Section: Discussionmentioning

confidence: 99%

Oculoplastic Conditions in Covid-19 Patients: Case Series and Literature Review

Yvon,

Patel,

et al. 2024

JOVR

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“…[53][54][55] Mucormycosis infections, [56] which are of exponentially increasing incidence in COVID-19 patients, can occur as a superinfection and result in lesions of the afferent or efferent visual pathways or even both. [57,58]…”

Section: Mechanisms Of Neurologic Involvement In Covid-19mentioning

confidence: 99%

Neuro-ophthalmic Manifestations of Coronavirus Disease 2019 and Its Vaccination: A Narrative Review

Feizi

Isen

Tavakoli

2023

JOVR

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Coronavirus disease 2019 (COVID-19) is a current pandemic caused by SARS-CoV-2 that has vastly affected the whole world. Although respiratory disease is the most common manifestation of COVID-19, the virus can affect multiple organs. Neurotropic aspects of the virus are increasingly unfolding, in so far as some respiratory failures are attributed to brainstem involvement. The neuro-ophthalmic manifestations of COVID-19 and the neuro-ophthalmic side effects of vaccination were reviewed. The major findings are that the SARS-CoV-2 infection commonly causes headaches and ocular pain. It can affect the afferent and efferent visual pathways by ischemic or inflammatory mechanisms. Optic nerve may be the origin of transient or permanent visual loss from papillophlebitis, idiopathic intracranial hypertension, or optic neuritis. Cerebrovascular strokes are not uncommon and may lead to cortical visual impairment or optic nerve infarction. SARSCoV- 2 may affect the pupillomotor pathways, resulting in tonic pupil (Adie’s syndrome) or Horner’s syndrome. Cranial neuropathies including third, fourth, sixth, and seventh nerve palsies have all been reported. Rhino-orbital mucormycosis superinfections in COVID-19 patients receiving steroids or other immunosuppressive therapies may result in unilateral or bilateral visual loss and ophthalmoplegia. Autoimmune conditions such as Guillain- Barré, Miller-Fisher syndrome, and ocular myasthenia have been reported.

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Perioperative Challenges in the Management of Rhino-Orbital Cerebral Mucormycosis

Bhalerao

Kuttarmare

Joshi

et al. 2022

Anesthesia Essays &Amp; Researches

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Background: Coronavirus disease 2019 (COVID-19) pandemic is the biggest threat of the century. Associated with this disease, are a number of rhino orbital cerebral mucormycosis cases seen as post COVID sequelae. Amphotericin B and surgical debridement are the treatment modalities. Aims: This study aimed to describe the clinical characteristics and perioperative outcomes of patients with ROCM. Settings and Design: This was a prospective, observational study. Materials and Methods: We carried out a study of 238 patients with confirmed ROCM posted for functional endoscopic sinus surgery, craniotomies, maxillofacial surgeries, and orbital exenteration under general anesthesia and the perioperative challenges therein. Statistical Analysis Used: Data were entered in the excel sheet. Descriptive statistics were used to summarize the data. Analysis was done using the Statistical Package for the Social Sciences (SPSS) version 27:0. Categorical variables were expressed as counts and percentages. Results: 78% had diabetes mellitus, 64% had received steroids, 59% had a preoperative oxygen saturation of less than 90%, 86% had a 4–6 zone involvement on chest radiograph, and more than 50% had an anticipated difficult airway. Postsurgery, 13% of patients required intensive care. The 15-day mortality rate was 3% among the operated cases. Conclusion: Post-COVID ROCM is challenging in terms of preoperative poor general condition, difficult airway, intraoperative concerns due to pathophysiology of the disease and its effect on organ systems, and the requirement of postoperative vigilant monitoring.

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Challenges and Pitfalls in the Management of Rhino-Orbital Mucormycosis in Ophthalmology: A Highlighted Problem in the COVID-19 Era

Cited by 3 publications

References 44 publications

Oculoplastic Conditions in Covid-19 Patients: Case Series and Literature Review

Oculoplastic Conditions in Covid-19 Patients: Case Series and Literature Review

Neuro-ophthalmic Manifestations of Coronavirus Disease 2019 and Its Vaccination: A Narrative Review

Perioperative Challenges in the Management of Rhino-Orbital Cerebral Mucormycosis

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