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Retrobulbar optic neuropathy associated with sphenoid sinus mucormycosis
Author(s) -
Sano Tatsuhiko,
Kobayashi Zen,
Takaoka Ken,
Ota Kiyobumi,
Onishi Iichiroh,
Iizuka Mihoko,
Tomimitsu Hiroyuki,
Shintani Shuzo
Publication year - 2018
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12216
Subject(s) - medicine , mucormycosis , optic nerve , sinus (botany) , optic neuropathy , surgery , optic canal , paranasal sinuses , orbit (dynamics) , ophthalmology , botany , biology , engineering , genus , aerospace engineering
Because fungi usually spread from the paranasal sinuses to the orbital apex in invasive fungal sinusitis ( IFS ), IFS often presents as an orbital apex syndrome ( OAS ) characterized by dysfunction of cranial nerves II, III, IV, V1, and VI. We report a case of sphenoid sinus mucormycosis that presented as isolated retrobulbar optic neuropathy. A 94‐year‐old woman presented with acute blindness in the right eye. Examination revealed the absence of light perception and pupillary reflex in the right eye. Head MRI showed a mass in the right sphenoid sinus, which was contiguous with the right optic nerve. She underwent endoscopic surgery, and a histopathological diagnosis of mucormycosis was established. Treatment with intravenous liposomal amphotericin B reduced the size of the mass. She has survived for more than 1 year without recurrence. Clinicians should consider that IFS can present as isolated retrobulbar optic neuropathy.