2018 Volume 111 Issue 10 Pages 675-680
Herein, we present the clinical courses of 8 patients with acute visual disorder caused by paranasal sinus diseases. The patients included 2 cases of sinus mucocele, 2 cases of fungal sinusitis, and 4 cases of chronic sinusitis. All the patients underwent endoscopic sinus surgery. The median interval between the onset of visual disorder and surgery was 5.5 days (range, 1 to 9 days), and the visual disorder improved in 7 of the 8 cases. On preoperative CT, the sinuses adjacent to the optic nerve were filled with a soft tissue density. Bony wall defects between the sinus and optic nerve were recognized in 6 cases. These pathological changes were thought to be one of the main causes for the visual disorder. Orbital and periorbital abscesses were seen in two cases. Antibiotics were administered to all patients postoperatively. Intravenous corticosteroids were administered in the 6 patients without fungal sinusitis. The antifungal drug, voriconazole, was administered to 3 patients, including 2 patients with fungal sinusitis and 1 patient with chronic sinusitis associated with dysfunction of cranial nerves III, V2 and VI, which was considered to be attributable to invasive fungal sinusitis. Emergent endoscopic sinus surgery is necessary to achieve a good prognosis in patients with acute visual disorder caused by sinus diseases.
