| 본문 : Purpose: To report a case of orbital apex syndrome caused by invasive fungal sinusitis
Case summary: A 82-year-old female, with uncontrolled diabetes mellitus, came to our clinic complaining of left visual disturbance over a period of 2 weeks. The left eye showed 40 prism diopter esotropia, mild ptosis, exophthalmos and severe limitation of abduction. Her best-corrected visual acuity was 0.8 in the right eye and 0.2 in the left eye. Brain magnetic resonance images with gadolinium contrast revealed an enhancing soft tissue lesion involving left cavernous sinus, orbital apex and pterygopalatine fossa. The patient diagnosed with orbital apex syndrome caused by invasive fungal sinusitis in the left eye. Despite intravenous antibiotic treatment, her symptoms progressed. Endoscopic sinus surgery was carried out. Two months later, her best-corrected visual acuity was 0.8 in the right eye and no light perception in the left eye. The left eye showed 25 prism diopter esotopia, 20 prism diopter hypertropia, and ophthlmoplegia. Fundus examination shewed pale disc. And visual evoke potential showed no P100 response in the left eye.
Conclusions: Sino-orbital invasive fungal infection has been regarded as a lethal disease. It is important for clinicians to be aware of the potential for invasive fungal sinusitis developing orbital apex syndrome.
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