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Abstract：
Potentially fatal fungal sphenoid sinusitis (FSS) causes visual damage. However, few studies have reported on its visual impairment and prognosis. Five hundred and eleven FSS patients with ocular complications treated at Beijing Tongren Hospital were recruited and clinical features and visual outcomes were determined. Thirty-two of the 511 patients (6%) had visual impairment, with 13 and 19 patients having invasive and noninvasive FSS, respectively. Eighteen patients (56.25%) had diabetes and 2 patient (6.25%) had long-term systemic use of antibiotics (n = 1) and corticosteroids (n = 1). All patients had visual impairment, which was more severe in invasive FSS than in noninvasive FSS. Bony wall defects and sclerosis were observed in 19 patients (59.38%), and 11 patients (34.38%) had microcalcification in their sphenoid sinusitis on computed tomography (CT). After a 5-year follow-up, three patients (9.38%) died. Patients with noninvasive FSS had a higher improvement rate in visual acuity than their counterparts. In the multivariate analysis, sphenoid sinus wall sclerosis on CT was associated with better visual prognosis. FSS can cause vision loss with persistent headaches, particularly in those with diabetes. CT showed the sphenoid sinus wall sclerosis, indicating a better visual prognosis in FSS with visual impairment.
摘要：
潜在致命的真菌性蝶窦炎（FSS）会导致视觉损伤。然而,很少有研究报道其视力损害和预后。收集了在北京同仁医院接受治疗的51111例眼部并发症的FSS患者，并确定了临床特征和视力结果。511例患者中有32例（6%）有视力障碍，13和19例患者有侵入性和非侵入性FSS，分别。18例患者（56.25％）患有糖尿病，2例患者（6.25％）长期全身使用抗生素（n=1）和皮质类固醇（n=1）。所有患者均有视力障碍,侵入性FSS比非侵入性FSS更严重。骨壁缺损和硬化19例(59.38%),11例患者（34.38％）在计算机断层扫描（CT）上有蝶窦炎的微钙化。经过5年的随访,3例(9.38%)死亡。非侵入性FSS患者的视力改善率高于其他患者。在多变量分析中，CT显示蝶窦窦壁硬化与较好的视觉预后相关。FSS可导致视力丧失并伴有持续性头痛，尤其是糖尿病患者。CT显示蝶窦壁硬化,表明有视力障碍的FSS具有更好的视力预后。
