Visual Loss due to Inflammatory Sinus Diseases

ABSTRACT

PURPOSE: Visual loss secondary to inflammatory sinus diseases is an infrequent but disastrous complication. We analyzed the clinical features of patients with paranasal sinusitis who had signs of optic nerve dysfunction. METHODS: Medical records of 10 patients (11 eyes), who presented with visual loss associated with inflammatory sinus diseases, were reviewed retrospectively. RESULTS: The mean age was 53.7 years (range, 33-68 years). Involved sinuses were the sphenoid (10 eyes) and posterior ethmoid (7 eyes). The radiological evidence of orbital apex infiltration was shown in 8 eyes. Headache was the most common presenting symptom. The mean symptom duration before their first visit was 51.4 days. The underlying sinus pathology included fungal infection (5) and mucoceles (5). Fungal sinusitis and initially lower visual acuity were associated with poor visual prognosis, while mucocele showed good prognosis. CONCLUSIONS: The inflammatory sinus disease could leave a permanent visual deficit, especially in cases of fungal sinusitis and initially lower visual acuity. Multidisciplinary diagnostic and therapeutic approaches are essential to prevent serious ophthalmic complications such as permanent visual loss.