Successful Treatment of Optic Neuropathy Associated with Sphenoid Sinus Aspergillosis

We report a case of optic neuropathy related to sphenoid sinus aspergillosis which showed good visual recovery with surgery and medical antifungal treatment.

Observational case study Case Presentation A 62-year-old man presented with decreased visual acuity in the right eye for 3 weeks. His visual acuity was counting fingers in the right eye and 20/20 in the left eye. Relative afferent pupillary defects were detected in the right eye. Optic neuropathy related to invasive fungal sphenoid sinusitis was suspected via radiologic evaluation. Endoscopic sinus surgery was performed and histopathological examination revealed aspergillosis. Amphotericin B combined with ceftriaxone and metronidazole was started. After the fungal culture results were positive for the Aspergillus species, amphotericin B was changed to voriconazole. At 1 month after surgery, visual acuity improved to 20/25.

Appropriate radiologic evaluation can be helpful when optic neuropathy associated with a fungal infection is suspected, and timely surgical and medial treatment should be considered.