DR.DR. SHRUTI KOCHAR MARU

DR SUMEET LAHANE, DR. RWITUJA THOMAS, DR. NEERAJ ISRANI

Abstract

Rhino-Orbital-Cerebral Mucormycosis (ROCM) can present in various forms, the most

common being ophthalmoplegia, with or without central retinal artery

occlusion(CRAO). Mucor has a tendency for angioinvasion leading to thrombosis of blood vessels and resultant tissue necrosis. Histopathological (HPE) analysis of the right optic nerve stump of an

exenterated specimen in a patient with ophthalmoplegia and CRAO revealed occlusion of the

central retinal artery secondary to invasion of its muscular coat by a fungus with aseptate

hyphae. Endothelial cell damage and activation of coagulation cascade is the key

pathophysiological mechanism for thrombus formation. This is the first reported direct

histopathological evidence of angioinvasion of the central retinal artery by Mucorales leading

to vision loss in a case of ROCM.