Affiliation:
1. Department of Orbit and Oculoplasty, Regional Institute of Ophthalmology and Government Ophthalmic Hospital, Chennai, Tamil Nadu, India
Abstract
Aim:
To study the role of retrobulbar (intraorbital) injection of amphotericin-B in the management of orbital mucormycosis.
Materials and Methods:
Patients with nasal diagnostic endoscopy or imaging confirmed, orbital mucormycosis were given 3 doses of 3.5 mg/ml of retrobulbar injection amphotericin-B for 3 alternate days and followed up for 72 hours for progression of symptoms.
Results:
Out of total 696 in-patients, 464 were males (66%) and 232 were females (34%), 612 were diabetic (88%), 490 were covid positive (71%), 308 patients have taken steroid (45%), 205 patients were given oxygen (30%). Out of 696 in-patients, 312 (45%) were started on retrobulbar injection of amphotericin. Dose wise-out of 312 retrobulbar injections, less than 3 doses is given for 69 patients (22%), 3 doses completed for 243 patients (78%). Outcomes-out of 243 three dose completed patients,49 (20%) patients has shown improvement in terms of vision and symptoms, 172 (71%) patients were stable without progression, 64 (26%) patients have shown deterioration out of which 35 patients progressed rapidly and undergone exenteration and remaining 29 are under observation.
Conclusion:
Retrobulbar injection of amphotericin-B along with iv amphotericin and sinus debridement through FESS have shown improvement and also halted the progression. Patients in stage 3a and 3b have shown better outcome with retrobulbar injection of amphotericin-b than in stage 3c and 3d.