A STUDY OF FEQUENCIES OF CRAO CASES IN POST COVID 19 RHINO ORBITAL MUCOR MYCOSIS

Introduction: Mucormycosis is a life-threatening fungal infection that occurs in patients who are immune compromised because of diabetic ketoacidosis, neutropenia and/or organ transplantation. In pandemic of COVID 19 an unusual epidemic of rhino-orbital-cerebral mucormycosis was observed affecting post COVID patients mainly. Covid 19 causes endothelial dysfunction due to inflammatory induced homeostasis and a pro coagulant state with multi-organ involvement[1].All these inflammatory and hypercoaguble states are established risk factors for retinal artery occlusion. Direct invasion of vessels by fungal hyphae leading to widespread occlusive vasculitis and thrombosis can also lead to complications like Central Retinal Artery Occlusion in patients of mucormycosis. Aim: To report a series of CRAO cases in Post Covid Rhino-orbito cerebral mucormycosis patients and describe clinical profile and outcome. Methodology: In a cross sectional study all adult patients at SDU medical college from 1st April to 31st August 2021 diagnosed as Rhino-orbital-cerebral Mucormycosis were included. Epidemiological data of all cases and relevant history were noted. Detailed history regarding COVID hospitalization and treatment received were noted. Detailed ocular examination including fundus examination was done.Primary outcome measure was CRAO. Results: A total of 34 patients were included in study out of which 26.47% were females and 73.52% were males. CRAO was observed in a total of 10 patients (27.02) out of which 9(90%) were males and 1(10%) was female. Conclusion: Association of invasive mucormycosis with COVID-19 is dangerous and has serious consequences. Detailed ophthalmological surveillance in such patients is mandatory to avoid sight threatening complications.