Serous retinal detachment in a patient with rhino-orbital mucormycosis.
BACKGROUND
Rhino-orbital mucormycosis is a difficult disease to treat. We report one case of rhino-orbital mucormycosis, complicated by serous retinal detachment, that responded to aggressive treatment.


METHODS
A 38-year-old man with diabetic ketoacidosis was referred to the emergency department of our hospital with fever, proptotic right eye, and complaint of lethargy.


METHODS
Fundus examination showed serous retinal detachment and focal lesions of retinitis with exudate at the inferior portion coincident with the position of opacification in the orbit on MRI. Fluorescein angiography showed pooling of dye in the detached retina and leakage from focal lesions of retinitis. We thoroughly removed the large necrotic materials in the orbit and sinus through the lower conjunctiva without enucleation or exenteration. Microscopic examination and culture of the necrotic materials that were removed from the orbit proved that the patient had mucormycosis. The serous retinal detachment improved 10 days after orbital debridement combined with intravenous and local (intraorbital) amphotericin B treatment. Visual acuity recovered to 20/50.


CONCLUSIONS
We propose that inflammation of the sclera in close contact with necrotic fungi materials may cause serous retinal detachment.
Kim
I T
IT
Department of Ophthalmology, School of Medicine, Kyungpook National University, Taegu, South Korea.
Shim
J Y
JY
Jung
B Y
BY
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D003646:Debridement; D016883:Diabetic Ketoacidosis / Q000150:complications; D015821:Eye Infections, Fungal / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009091:Mucormycosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D009336:Necrosis; D009916:Orbital Diseases / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D010254:Paranasal Sinus Diseases / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D012163:Retinal Detachment / Q000209:etiology*; D014792:Visual Acuity
D000935:Antifungal Agents; D000666:Amphotericin B