Risk Factors of Rhino Orbital Mucormycosis

Area of Science:

• Ophthalmology
• Infectious Diseases
• Medical Mycology

Background:

• Mucormycosis is a severe fungal infection caused by Mucoraceae family fungi.
• Inhalation of spores leads to infection, potentially spreading to the sinuses, orbit, and brain.
• A rise in rhino-orbital mucormycosis cases has been observed during the COVID-19 pandemic, particularly in immunocompromised individuals.

Purpose of the Study:

• To investigate the clinical presentation of rhino orbital mucormycosis.
• To identify risk factors associated with rhino orbital mucormycosis.

Main Methods:

• A prospective, single-center, cross-sectional study was conducted.
• Patients underwent detailed history taking (including COVID-19, steroid use, diabetes, oxygen use) and comprehensive ophthalmic evaluations.
• Paranasal sinus CT scans and, in some cases, MRI were performed. Potassium Hydroxide (KOH) staining of intraoperative samples confirmed the diagnosis.

Main Results:

• The study included 40 participants (85% male, mean age 51.75 years).
• Key risk factors identified were: prior COVID-19 infection (72.5%), type 2 diabetes mellitus (75%), steroid intake (62.5%), and oxygen use (62.5%).
• Ocular manifestations included low vision (42.5%), ptosis (75%), proptosis (55%), limited ocular motility (37.5%), ophthalmoplegia (27.5%), and central retinal artery occlusion (27.5%).

Conclusions:

• Rhino orbital mucormycosis is significantly associated with COVID-19 infection, steroid and oxygen use, and type 2 diabetes mellitus.
• Prompt diagnosis and treatment are essential to mitigate ocular morbidity and prevent vision loss.