Patients’, Globe, and Vision Survivals in Rhino-Orbito-Cerebral Mucormycosis

Purpose: To report the frequency and factors affecting patients’, globe, and vision survivals in rhino-orbitocerebral mucormycosis (ROCM). Methods: This is a retrospective study of 63 patients (79 eyes) with biopsy proven ROCM at a university hospital (2008-2016). Systemic and ophthalmic manifestations, imaging, management, and final outcomes were recorded. Globe survival was defined as no exenteration and vision survival as final visual acuity of light perception and more. Results: Mean age was 55.5 (SD:12.9) years old with no gender preference. Diabetes was the most common underlying disease (68.3%). Patients’ survival was observed in 57.1% (36/63). Presence of frozen eye (OR=4.6), nasal mucosal involvement (OR=7.3), and shorter duration of anti-fungal therapy (OR= 1.03) were significantly associated with lower patients’ survival. Exenteration did not significantly change the survival. Globe survival was detected in 43% (34/79). Higher white-blood-cell (WBC) count was associated with a lower globe survival (P=0.02). Vision survival was observed in 25.3% (20/79) in whom younger age was significantly associated with a worse vision survival.Conclusion: Patients’, globe, and vision survivals were 57%, 43% and 25%. Exenteration did not affect the patients’ survival. While frozen eye, nasal mucosal involvement, and shorter duration of treatment were significantly associated with a lower survival, higher WBC count significantly increased the risk of exenteration