NEUROOPHTHALMOLOGICAL PRESENTATION OF NONINVASIVE ASPERGILLUS SINUS DISEASE IN THE NONIMMUNOCOMPROMISED HOST

Two cases of non-invasive aspergillosis of the nose and paranasal sinu ses are described. The first presented with left proptosis and ophthal moplegia. Imaging and histology showed a maxillary sinus aspergilloma. The second case presented as a compressive optic neuropathy and histo logy showed allergic aspergillus sinusitis. The pathological distincti on between invasive and non-invasive forms of aspergillus sinusitis is important as in invasive aspergillosis surgical treatment is most eff ectively combined with systemic antifungal treatment, whereas in asper gilloma of the paranasal sinuses surgical drainage of the sinuses alon e is usually sufficient, and in allergic aspergillus sinusitis surgery is best combined with systemic or topical steroids. The distinction b etween invasive and noninvasive forms is particularly important as bot h may present with cranial neuropathies.