Optic neuropathy due to allergic fungal rhinosinusitis

Loss of Vision Outcome for Allergic Fungal Sinusitis: Case Report and Literature Review

Visual loss is a rare manifestation of allergic fungal rhinosinusitis (AFRS). We report a case of an adult male who was diagnosed with AFRS and who presented during the COVID-19 pandemic lockdown with sudden-onset complete vision loss and a lack of recovery after surgical and medical management. We reviewed the literature on reported cases of AFRS complicated by visual loss to identify factors associated with visual outcomes. We found 50 patients who were diagnosed with acute visual loss due to AFRS, with an average age of 28 ± 14 years. Complete and partial recovery after surgical intervention were reported in 17 and 10 cases, respectively. However, the absence of vision improvement was reported in 14 of the cases. Early diagnosis and prompt intervention can return vision back to normal. However, delayed presentation, complete loss of vision, and acute onset of visual loss are associated with worse outcomes.

Permanent Unilateral Vision Loss From Allergic Fungal Sinusitis

ABSTRACT

In the absence of trauma, sudden unilateral painless visual loss is an uncommon condition in the pediatric population requiring emergent medical evaluation. In the acute care setting, clinicians face the challenge of accurately assessing the patient and determining the initial diagnostic workup. A careful history alone helps guide diagnosis with sudden visual loss that is unilateral and persistent. Several neuro-ophthalmological conditions that present with these characteristics include retinal artery or vein occlusion, diseases affecting the cavernous sinus or orbital apex region, and optic neuropathy. Simple eye examination techniques have crucial diagnostic value in helping localize the disease process, determining the level of urgency, and need for timely intervention. Here we present an adolescent patient with nontraumatic, acute unilateral visual loss who had concerning ophthalmological examination findings and was subsequently diagnosed with optic neuropathy secondary to allergic fungal sinusitis.

Swollen Optic Disc and Sinusitis

PURPOSE

To present a case of optic disc swelling caused by sinusitis.

METHODS

Ocular symptoms were investigated using computed tomography imaging of the facial bones to detect the relationship between the sinus inflammation and the optic nerve.

RESULTS

A particular configuration of the optic nerve was detected. Optic nerve course through the inflamed sphenoidal sinus is a condition associated with a greater risk of inflammation.

CONCLUSION

Sinusitis is a rare but treatable cause of optic neuritis. The choice of the correct radiological investigation to be done to set up a proper treatment of the sinus pathological condition is also essential for the resolution of ocular symptoms.