Compressive Optic Neuropathy from Allergic Fungal Sinusitis

ABSTRACT

Ophthalmic manifestations of allergic fungal sinusitis (AFS) are rare, but can occur in advanced disease. A 32-year-old man with advanced AFS presented with severe bilateral vision loss and restricted ocular motility. Magnetic resonance imaging and histological analysis confirmed active chronic AFS. Functional endoscopic sinus surgery was performed, with adjunctive steroid therapy. Although AFS is a reasonably well-recognised entity, severe disease causing bilateral visual deficits is rarely encountered. This can confound the diagnosis and appropriate treatment. Ophthalmologists should thus be aware of compressive optic neuropathy as a complication of advanced AFS to prompt early treatment and mitigate visual loss.

• Allergic fungal sinusitis
• compressive optic neuropathy
• magnetic resonance imaging

ACKNOWLEDGEMENTS

We would like to thank the following contributors for their valuable assistance: Ms. Christina Peterson for supplying the Humphrey visual field, OCT, and ocular motility test results; and Dr. Georgina Clark for her contributions in the peri-operative review of the patient.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.