Delhi Journal of Ophthalmology

Retrobulbar Amphotericin B in Mucormycosis: A Ray of Hope

Shalini Mohan1, Kunal Sahai2, Namrata Patel1, Tejasvini Chandra1, Priyesh Kumar1
1Department of Ophthalmology, GSVM Medical College, Kanpur, India.
2Department of Medicine,  GSVM Medical College, Kanpur, India.

Editor-in-Chief, Delhi Journal of Ophthalmology, Dr R.P.Centre, AIIMS.


Corresponding Author:

Shalini Mohan (MS,DNB, Associate Prof)
Department of Ophthalmology, 
GSVM Medical College, Kanpur, UP, India.
Email: shalinimohan.dr@gmail.com 


Received: 02-JAN-2022 Accepted: 10-FEB-2022 Published Online: 03-APR-2022
DOI: https://dx.doi.org/10.7869/djo.739

Abstract
Aim: The aim of the study was to study the role of Retrobulbar Amphotericin B in patients with Mucormycosis.

Methods: The retrospective study conducted on 86 cases at a tertiary care hospital analyzed detailed history, examination and management options. The staging was done on basis of clinical and radiological examination. Management included functional endoscopic sinus debridement followed by lavage with Liposomal Amphotericin B. The patients with ocular involvement were subjected to Exenteration or Retrobulbar injections of Amphotericin B (3.5 mg / ml) based on the disease staging.

Results: Most common risk factors were steroid intake (89.5 %) and Diabetes (87.2%). Seventy four eyes of 71 patients had ocular involvement out of which 20 eyes (27.0%) of 19 patients (26.7%) presented with no perception of light. Seven patients were subject to exenteration of globe and 58 eyes were given Retrobulbar injections (Mean number of injections = 5.58 ± 2.36).The mean best corrected visual acuity of 0.769± 0.935 logMar did not deteriorate (p=0.871) post treatment. The mean restriction of extraocular movements were 2.32± 1.09 which improved to 1.56 ± 1.56 (p=0.0031) following retrobulbar injections. 

Conclusion: The patients of Mucormycosis without cerebral involvement can be subjected to Retrobulbar Amphotericin B injections that can control the ocular manifestations and stabilise the vision thus saving the globe.

Keywords :Amphotericin B, Covid, Exenteration, Mucormycosis, Retrobulbar Injection