Rhino Orbital Cerebral Mucormycosis with Central Retinal Artery Occlusion: Case Series and Review of Literature

Abstract

Background: Mucormycosis is a rare, aggressive fungal infection. It frequently affects immunocompromised individuals, leading to devastating outcomes. This study explores 4 cases of mucormycosis-induced central retinal artery occlusion (CRAO). Case presentation: This case series includes four patients aged 50-57 years with uncontrolled diabetes mellitus. They presented with a sudden onset of severe unilateral visual loss, orbital symptoms, and systemic involvement. Each patient underwent a combination of nasal endoscopy, biopsy, and neuroimaging. A variety of treatment modalities were used, including antifungal therapy, intravenous antibiotics, surgery, and intravitreal injections. Despite intensive medical and surgical management, two patients succumbed to the disease. One patient, despite refusing further surgical intervention, was able to control the spread of infection with long-term medical management but suffered significant vision loss. Another patient showed some improvement in orbital symptoms but remained visually impaired. Conclusion: Mucormycosis-induced CRAO in patients with diabetes mellitus represents a severe and challenging clinical scenario, often culminating in profound vision loss or death despite aggressive treatment. These findings highlight the critical importance of early recognition, prompt intervention, and meticulous long-term management in these high-risk patients.