Outcomes and factors affecting them in patients with rhino-orbito-cerebral mucormycosis
- 4 December 2018
- journal article
- research article
- Published by BMJ in British Journal of Ophthalmology
- Vol. 103 (10), 1460-1465
- https://doi.org/10.1136/bjophthalmol-2018-312688
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.Funding Information
- Iran University of Medical Sciences (IR.IUMS.REC 1394.26261)
This publication has 16 references indexed in Scilit:
- Rhino-Orbital-Cerebral MucormycosisCurrent Infectious Disease Reports, 2012
- Rhinocerebral mucormycosis: experience in 14 patientsThe Journal of Laryngology & Otology, 2011
- Rhinocerebral Mucormycosis: Consideration of prognostic factors and treatment modalityAuris Nasus Larynx, 2009
- Delaying Amphotericin B–Based Frontline Therapy Significantly Increases Mortality among Patients with Hematologic Malignancy Who Have ZygomycosisClinical Infectious Diseases, 2008
- Combination Polyene‐Caspofungin Treatment of Rhino‐Orbital‐Cerebral MucormycosisClinical Infectious Diseases, 2008
- Epidemiology and Outcome of Zygomycosis: A Review of 929 Reported CasesClinical Infectious Diseases, 2005
- Novel Perspectives on Mucormycosis: Pathophysiology, Presentation, and ManagementClinical Microbiology Reviews, 2005
- Improving outcomes in rhinocerebral mucormycosis - early diagnostic pointers and prognostic factorsThe Journal of Laryngology & Otology, 2003
- Survival factors in rhino-orbital-cerebral mucormycosisSurvey of Ophthalmology, 1994
- Patient survival factors in paranasal sinus mucormycosisThe Laryngoscope, 1980