A case of fungal infection of the orbit presenting as orbital apex syndrome Sentaro Kusuhara 1 , Hiroyuki Yamamoto 1 , Atsushi Azumi 1 , Akira Negi 1 1Dept of Organ Therapeutics Division of Ophthalmol, Kobe Univ Graduate Sch of Med pp.283-287
Published Date 2002/3/15
DOI https://doi.org/10.11477/mf.1410907629
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A 75-year-old woman was referred to us for orbital apex syndrome in her right eye since 5 weeks before. She had been receiving systemic corticosteroid for trigeminal neuralgia during the past one month. Her corrected vis-ual acuity was no light perception right and 1.0 left. Magnetic resonance imaging (MRI) showed a large invasive lesion in the ethmoid sinuses and orbital apex of the right eye. A fungal infection was suspected and systemic antifuncal treat-ment was initiated. Biopsy of the orbit by anterior approach showed an inflammatory pseudotumor, leading to addi-tional radiation and corticosteroid. Five months after her initial visit, the visual acuity in the left eye decreased to no light perception. Transnasal ethmoidectomy and decompression of the optic canal showed a fungal mass in the right ethmoid sinus which was identified as aspergilloma. The patient died of cranial infection 3 weeks later. Orbital apex syndrome caused by fungal infection is often life-threatening. Ophthalmologists, together with other specialists, should take the initiative for proper diagnosis and treatment.

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