title: Isolated Orbital Aspergillosis in Immunocompetent Patients: A Multicenter Study.
abstract: OBJECTIVE
  To report clinicopathologic features, radiologic findings, and treatment outcomes of isolated, orbital aspergillosis.
  
  
  METHODS
  Multicenter, retrospective case series.
  
  
  METHODS
  setting: Multicenter.
  
  
  METHODS
  There were 8 lesions in 8 eyes of 8 patients with isolated, orbital aspergillosis.
  
  
  METHODS
  Review of medical records and histopathology slides.
  
  
  METHODS
  Disease control.
  
  
  RESULTS
  Of 34 patients with orbital aspergillosis, 8 (23.5%) had isolated orbital involvement at presentation. The mean age at presentation was 34.5 years (median, 43 years: range, 0.5-72 years). Gradually progressive proptosis and eyelid swelling were the most common presenting features (each 4/8). Proptosis ranged from 4 mm to 9 mm (median, 5.5 mm; mean, 5.75 mm). Restriction of ocular motility was seen in all 8 patients. Other examination findings included palpable mass (2/8), conjunctival chemosis (2/8), hyperglobus (1/8), hypoglobus (1/8), and resistance to retropulsion (1/8). Microbial culture results were available in 1 patient and showed Aspergillus fumigatus. Two patients were treated with complete surgical excision alone while 6 were treated with antifungal medications. Complete resolution of proptosis and restoration of ocular motility were seen in all patients following treatment. Visual disturbances present in 1 were corrected following treatment. Recurrence was observed in 1 patient.
  
  
  CONCLUSIONS
  Isolated orbital aspergillosis, though rare, should be considered in the differential diagnosis of a patient presenting with a gradually progressive orbital mass, especially in Asian individuals. Early recognition will help reduce the morbidity and mortality associated with this disease.
authors.affiliation: Drishti Eye Care and Vasan Eye Care Hospitals, Hyderabad, India. Electronic address: drektaoph@gmail.com.
authors.forename: Ekta
authors.initials: E
authors.lastname: Aggarwal
authors.affiliation: National Reporting Centre for Ophthalmic Pathology (NRCOP), Centre For Sight, Hyderabad, India.
authors.forename: Kaustubh
authors.initials: K
authors.lastname: Mulay
authors.affiliation: Oculoplastics, Facial Aesthetics and Ocular Oncology, Centre For Sight, New Delhi, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Menon
authors.affiliation: Orbit and Oculofacial Surgery, Department of Ophthalmology, National University Hospital, Singapore.
authors.forename: Gangadhara
authors.initials: G
authors.lastname: Sundar
authors.affiliation: Oculoplastics, Facial Aesthetics and Ocular Oncology, Centre For Sight, Hyderabad, India.
authors.forename: Santosh G
authors.initials: SG
authors.lastname: Honavar
authors.affiliation: Oculoplastics, Facial Aesthetics and Ocular Oncology, Centre For Sight, Jaipur, India.
authors.forename: Mukesh
authors.initials: M
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D002648:Child; D003937:Diagnosis, Differential; D005094:Exophthalmos / Q000175:diagnosis; D015821:Eye Infections, Fungal / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007121:Immunocompetence; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000175:diagnosis; D013508:Ophthalmologic Surgical Procedures; D009916:Orbital Diseases / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D000935:Antifungal Agents