TO PREVENT CASE FATALITY AND REDUCING OCULAR MORBIDITY THROUGH EARLY DIAGNOSIS AND PROMPT MANAGEMENT OF ORBITAL MUCORMYCOSIS IN DIABETES MELLITUS

Abstract

Background & Method: This study was conducted in Amaltas Institute of Medical Sciences, Dewas, M.P. for a period of 12 months. 30 patients were selected based upon the inclusion criteria.  Patients were admitted and evaluated clinically and radiologically. All the patients were given similar medical and appropriate surgical therapy and closely monitored for changes in the subjective symptoms and objective signs throughout the treatment period. Patients will be followed up at 1, 4, 6 weeks and 3, 6, 12 months. On each follow up visit, visual acuity, slit lamp examination, IDO, IOP measurement will be recorded and also assessed for development of possible complications which will be managed accordingly.

Result: As recorded in our study, uncontrolled diabetes (50%) was the most common cause for deterioration of the general condition of the patient, followed by poor compliance (33%) to treatment and death (17%).In our study, pre septal cellulitis (67%) was the most common orbital manifestation of mucormycosis followed by orbital cellulitis (17%) and cavernous sinus thrombosis (10%). Very few had a sub periosteal or an orbital abscess.

Conclusion: All the patients were subjected to similar treatment strategy of systemic anti-fungal therapy followed by appropriate surgical methods with respect to the stage of presentation. The changes in the subjective symptoms and objective signs after treatment were evaluated, along with the assessment of development of possible complications. Residual morbidity and high mortality occurs if clinical diagnosis is delayed.

Keywords: fatality, morbidity, mucormycosis & DM.