Duration 5min, Q&A 3min
Ophthalmic Manifestations of Allergic Fungal Sinusitis
Purpose: To study the ophthalmic manifestations of patients with allergic fungal sinusitis (AFS) presented to a tertiary hospital and evaluate the importance of early diagnosis and management in preventing the possible complications of AFS.
Retrospective case series.
Methods: Retrospective charts review of 100 patients with the diagnosis of AFS were reviewed. Age, gender, clinical presentation including ophthalmic findings, immune status, patterns of sinus involvement, radiological findings, medical and surgical intervention needed, laboratory results, and the course of the disease including the patients condition in the last clinical visit were studied.
Results and Conclusion
Results: The mean age at presentation was 19.8 years (range 10-42 years) with no clear gender predominance (52% of patients were female). Computed tomography (CT) scans showed that 52% of patients had erosion of lamina papyracea, 17.6% had intraorbital extension and 8.8% had intracranial extension. Thirty-four patients had ophthalmic complications. The most common ophthalmic presentation was proptosis (n=21, 61.7%), followed by epiphora (n=5, 14.7%), visual loss (n=4, 11.7%), diplopia (n=3, 8.8%) and dystopia (n=1, 2.9%). Immune profiles were similar to other AFS patients without ophthalmic sequelea. The most common sinus involved was ethmoid and maxillary sinuses. Aspirgillus spp is the most common fungal type in this review. All patients underwent functional endoscopic sinus surgery (FESS) and received systemic and topical steroid. There were no intervention related complications.
Conclusion: ophthalmologist may be the first who encounter these patients which necessitates familiarity with AFS presentations & complications. Early diagnosis and management may help in reaching a favorable outcome.
[ Keyword ]
sinusitis, hypersensitivity, prptosis,blindness.
[ Conflict of Interest ]