title: [A case of orbital apex syndrome due to aspergillus infection that avoided loss of visual acuity by optic canal decompression].
abstract: A 71-year-old woman was admitted to our hospital complaining of left orbital pain, headache, diplopia and left-sided ptosis, which she had suffered for two months. On examination, the patient had loss of visual acuity, left-sided ptosis, lateral gaze disturbance, and was diagnosed as having left orbital apex syndrome. An abnormal signal to the left orbital cone was detected on MRI. Serum β-D-glucan was increased, and serum Aspergillus antigen and antibody were both positive. Although antifungal drugs (voriconazole and liposomal amphotericin B) were administered, the symptoms deteriorated. The patient then underwent optic nerve decompression surgery and was treated with intravenous methylprednisolone, which gradually improved the patient's symptoms, Aspergillus hyphae were confirmed by pathological examination. To obtain good prognosis for patients with orbital apex syndrome associated with Aspergillus infection, optic nerve decompression surgery should be considered.
authors.affiliation: Department of Neurology, Neurological Institute, Ohta-Atami Hospital.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yoshida
authors.forename: Akiko
authors.initials: A
authors.lastname: Shirata
authors.forename: Taku
authors.initials: T
authors.lastname: Sato
authors.forename: Yugo
authors.initials: Y
authors.lastname: Kishida
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Saito
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Yamane
mesh_terms: D000368:Aged; D001228:Aspergillosis / Q000150:complications* / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000008:administration & dosage; D009900:Optic Nerve / Q000000981:diagnostic imaging / Q000601:surgery*; D020551:Pulse Therapy, Drug; D013577:Syndrome; D014786:Vision Disorders / Q000382:microbiology* / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy; D014792:Visual Acuity
chemical_list: D015415:Biomarkers; D008775:Methylprednisolone