Neuro-Ophthalmic Manifestations in Sinusitis Patients Who Underwent Endoscopic Sinus Surgery

Kitthisak Kitthaweesin MD*, Triyapa Theerakul MD*

Affiliation : * Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

Objective : To describe neuro-ophthalmic manifestations in sinusitis patients who underwent functional endoscopic sinus surgery Material and Method: The medical records of 341 patients who underwent functional endoscopic sinus surgery (FESS) between October and January 2001 were reviewed in this retrospective study.
Results : Patient mean age was 37.09 years (range, 3-77) and 171(50.15%) patients had no underlying disease. Visual loss and limited ocular motility were revealed in 43 (12.72%) and 40 (11.83%) patients, respectively. Sphenoid sinus was the most commonly affected sinus in patients presenting with either visual loss (odds ratio 5.88; 95% CI 2.79-12.38) or ophthalmoplegia (OR 7.09; 95% CI 3.28-15.32). Twenty-three percent of patients with visual loss had abnormal funduscopy, while 30.23% had abnormal radiologic imaging study. After FESS, 12 (27.91%) patients had better visual acuity, but 11 (25.58%) had permanent visual loss. Isolated oculomotor and combined oculomotor with abducens nerve involvement were revealed in nine (22.50%), and 31 (77.5%) patients, respectively. Diabetes was a significant risk factor associated with ocular complications in patients with either visual loss (OR 2.98; 95% CI 1.37-6.44) or ophthalmoplegia (OR 2.56; 95% CI 1.17-5.61).
Conclusion : Sphenoid sinusitis significantly increased the risk of neuro-ophthalmic manifestations, particularly among diabetic patients.

Keywords : Optic neuropathy, Ophthalmoplegia, Sinusitis, Visual loss

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