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Long-term outcomes of transcutaneous retrobulbar amphotericin B in COVID-19-associated mucormycosis
PURPOSE: To describe the long-term outcomes of transcutaneous retrobulbar amphotericin B (TRAMB) in COVID-19-associated mucormycosis. METHODS: In total, 18 cases of COVID-19-associated mucormycosis were reviewed. In addition to the recommended treatment protocol, all patients were to be given 3.5 mg...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228905/ https://www.ncbi.nlm.nih.gov/pubmed/36727338 http://dx.doi.org/10.4103/ijo.IJO_1382_22 |
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author | Rizvi, Syed Wajahat A Khan, Shagil Shahbaz, Mohammad Gounder, M Srinivasan Saif, Mohd Khalid, Saifullah |
author_facet | Rizvi, Syed Wajahat A Khan, Shagil Shahbaz, Mohammad Gounder, M Srinivasan Saif, Mohd Khalid, Saifullah |
author_sort | Rizvi, Syed Wajahat A |
collection | PubMed |
description | PURPOSE: To describe the long-term outcomes of transcutaneous retrobulbar amphotericin B (TRAMB) in COVID-19-associated mucormycosis. METHODS: In total, 18 cases of COVID-19-associated mucormycosis were reviewed. In addition to the recommended treatment protocol, all patients were to be given 3.5 mg/ml/day of TRAMB for five days. RESULTS: Of the 18 patients, 2 presented with stage 3a disease, 13 had stage 3c disease, and 3 patients had central nervous system (CNS) involvement (stage 4a and 4c). In addition to planned retrobulbar doses, five patients were given more while two patients received fewer injections (i.e., <5). At the last mean follow-up of 34.67 (±8.88) weeks, 11 patients were in radiological regression and 4 had stable disease while 2 patients had to undergo exenteration; one mortality was observed because of disease progression. Clinical regression in terms of visual and ptosis improvement was seen in seven and nine patients, respectively. CONCLUSION: Rhino-orbito-cerebral mucormycosis is a serious condition which warrants an aggressive treatment strategy. In unprecedented situations witnessed recently, TRAMB turned out to be an effective and economical alternative. Though large randomized studies are needed to establish its efficacy, TRAMB still manages to halt progression and salvage the globe in significant number of patients, and hence its use should be encouraged on a case-to-case basis especially in developing countries with limited resources. |
format | Online Article Text |
id | pubmed-10228905 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-102289052023-05-31 Long-term outcomes of transcutaneous retrobulbar amphotericin B in COVID-19-associated mucormycosis Rizvi, Syed Wajahat A Khan, Shagil Shahbaz, Mohammad Gounder, M Srinivasan Saif, Mohd Khalid, Saifullah Indian J Ophthalmol Original Article PURPOSE: To describe the long-term outcomes of transcutaneous retrobulbar amphotericin B (TRAMB) in COVID-19-associated mucormycosis. METHODS: In total, 18 cases of COVID-19-associated mucormycosis were reviewed. In addition to the recommended treatment protocol, all patients were to be given 3.5 mg/ml/day of TRAMB for five days. RESULTS: Of the 18 patients, 2 presented with stage 3a disease, 13 had stage 3c disease, and 3 patients had central nervous system (CNS) involvement (stage 4a and 4c). In addition to planned retrobulbar doses, five patients were given more while two patients received fewer injections (i.e., <5). At the last mean follow-up of 34.67 (±8.88) weeks, 11 patients were in radiological regression and 4 had stable disease while 2 patients had to undergo exenteration; one mortality was observed because of disease progression. Clinical regression in terms of visual and ptosis improvement was seen in seven and nine patients, respectively. CONCLUSION: Rhino-orbito-cerebral mucormycosis is a serious condition which warrants an aggressive treatment strategy. In unprecedented situations witnessed recently, TRAMB turned out to be an effective and economical alternative. Though large randomized studies are needed to establish its efficacy, TRAMB still manages to halt progression and salvage the globe in significant number of patients, and hence its use should be encouraged on a case-to-case basis especially in developing countries with limited resources. Wolters Kluwer - Medknow 2023-02 2023-02-02 /pmc/articles/PMC10228905/ /pubmed/36727338 http://dx.doi.org/10.4103/ijo.IJO_1382_22 Text en Copyright: © 2023 Indian Journal of Ophthalmology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Rizvi, Syed Wajahat A Khan, Shagil Shahbaz, Mohammad Gounder, M Srinivasan Saif, Mohd Khalid, Saifullah Long-term outcomes of transcutaneous retrobulbar amphotericin B in COVID-19-associated mucormycosis |
title | Long-term outcomes of transcutaneous retrobulbar amphotericin B in COVID-19-associated mucormycosis |
title_full | Long-term outcomes of transcutaneous retrobulbar amphotericin B in COVID-19-associated mucormycosis |
title_fullStr | Long-term outcomes of transcutaneous retrobulbar amphotericin B in COVID-19-associated mucormycosis |
title_full_unstemmed | Long-term outcomes of transcutaneous retrobulbar amphotericin B in COVID-19-associated mucormycosis |
title_short | Long-term outcomes of transcutaneous retrobulbar amphotericin B in COVID-19-associated mucormycosis |
title_sort | long-term outcomes of transcutaneous retrobulbar amphotericin b in covid-19-associated mucormycosis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228905/ https://www.ncbi.nlm.nih.gov/pubmed/36727338 http://dx.doi.org/10.4103/ijo.IJO_1382_22 |
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