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Neuro-ophthalmology and Strabismus

Trief D, Gray ST, Jakobiec FA et al.

Harvard Medical School, Boston, MA, USA.

 Br J Ophthalmol 2016;100:184–8.

Eoin O’Sullivan’s review: The authors of this study performed a retrospective review of the medical notes of patients with a confirmed pathological diagnosis of invasive fungal disease of the sinus and/or orbit who were seen at the Massachusetts Eye and Ear Infirmary (Boston, MA, USA) over a 20-year period (1994–2014). A total of 24 patients were identified: 16 men and eight women. The age range was 30–80years (mean 55years). Fourteen patients had disease affecting the orbit. Mucormycosis was the fungus present in 14 patients (58%), Aspergillus was present in seven (29%), both mucormycosis and Aspergillus were present in one patient, one patient had an infection caused by a dematiaceous fungus, and in one patient the fungal disease was unidentified.

Thirteen patients (54%) died, 11 of whom had orbital disease. Of the patients who died, 10 had a pathological diagnosis of mucormycosis, two had Aspergillus, and one had a fungal infection of indeterminate species. The majority (11 of 14) of the orbital infections were secondary to mucormycosis, and the majority of orbit-sparing sinus infections (six of 10) were secondary to Aspergillus.

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