Serous retinal detachment in a patient with rhino-orbital mucormycosis

Background: Rhino-orbital mucormycosis is a difficult disease to treat. We report one case of rhino-orbital mucormycosis, complicated by serous retina l detachment, that responded to aggressive treatment. Case: A 38-year-old man with diabetic ketoacidosis was referred to the emer gency department of our hospital with fever, proptotic right eye, and compl aint of lethargy. Observations: Fundus examination showed serous retinal detachment and focal lesions of retinitis with exudate at the inferior portion coincident with the position of opacification in the orbit on MRI. Fluorescein angiography showed pooling of dye in the detached retina and leakage from focal lesions of retinitis. We thoroughly removed the large necrotic materials in the or bit and sinus through the lower conjunctiva without enucleation or exentera tion. Microscopic examination and culture of the necrotic materials that we re removed from the orbit proved that the patient had mucormycosis. The ser ous retinal detachment improved 10 days after orbital debridement combined with intravenous and local (intraorbital) amphotericin B treatment. Visual acuity recovered to 20/50. Conclusion: We propose that inflammation of the sclera in close contact wit h necrotic fungi materials may cause serous retinal detachment. (C) 2001 Ja panese Ophthalmological Society.