Retrobulbar Injection of Amphotericin B for Orbital Mucormycosis

Ophthalmic Plast Reconstr Surg. 2017 Jul/Aug;33(4):e94-e97. doi: 10.1097/IOP.0000000000000806.

Abstract

A 68-year-old immunocompromised man with rhino-orbital-cerebral mucormycosis was treated with retrobulbar injections of amphotericin B deoxycholate in conjunction with intravenous antifungals and endoscopic sinus debridement. Transient episodes of orbital inflammation were noted after retrobulbar injections, but progression of orbital infection was halted and visual acuity restored with eventual hospital discharge. To the authors' knowledge, clearance of orbital mucormycosis with retrobulbar amphotericin B injections has not been previously reported. This intervention may be a viable therapeutic option in cases of orbital mucormycosis where aggressive orbital debridement is not favored and/or the burden of orbital disease is not substantial. However, physicians should be aware of the risk of transient orbital inflammation secondary to retrobulbar amphotericin B deoxycholate.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amphotericin B / administration & dosage*
  • Antifungal Agents / administration & dosage
  • Endoscopy
  • Eye Infections, Fungal / diagnosis
  • Eye Infections, Fungal / drug therapy*
  • Follow-Up Studies
  • Humans
  • Immunocompromised Host*
  • Injections, Intraocular
  • Magnetic Resonance Imaging
  • Male
  • Mucormycosis / diagnosis
  • Mucormycosis / drug therapy*
  • Orbital Diseases / diagnosis
  • Orbital Diseases / drug therapy*
  • Visual Acuity

Substances

  • Antifungal Agents
  • Amphotericin B