Orbital mucormycosis post-COVID-19: Demographics, clinical features, and treatment outcomes

To investigate the demographic profile, risk factors, clinical manifestations, and treatment outcomes of patients with orbital mucormycosis in the post-COVID-19 context.

Retrospective analysis was conducted on the medical records of patients diagnosed with biopsy proven orbital mucormycosis following a confirmed or suspected history of COVID-19 infection. Data regarding demographic features, personal profile, COVID-19 status, ocular manifestations, radiological findings, treatment modalities, and outcomes were collected and analyzed.

Among the 14 patients in the study, the duration between COVID-19 onset and mucormycosis onset was 14.1 days on average. Comorbidities, particularly diabetes mellitus and hypertension, were prevalent among both COVID-19-positive and COVID-19-negative patients. Ocular manifestations at presentation included pain (80%), lid edema (100%), restricted extraocular movements (86.67%), and proptosis (53.33%). Ethmoid sinus involvement was most common (33.34%), along with pterygopalatine and inferior orbital fissure involvement (66.67%). Sinus debridement was the primary treatment modality (93.34%), with transcutaneous retrobulbar amphotericin B (TRAM-B) used in 46.67% of cases. Among 14 patients, 80% achieved globe salvage, while 40% had improved visual acuity and motility. Significant prognostic factors included intracranial extension and ICU admission.

Aggressive surgical and antifungal management, supported by a multidisciplinary approach, improves outcomes in this life-threatening condition.