{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T20:25:36Z","timestamp":1760300736534,"version":"3.44.0"},"reference-count":9,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,3,17]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>We aim to highlight the role of transcutaneous retrobulbar amphotericin-B (TRAMB) in cases of rhino-orbital mucormycosis. With the COVID-19 pandemic a rapid surge in the number of cases of rhino-orbital mucormycosis has been noted. The gold standard treatment for the progressive orbital disease is exenteration; however, organ salvage should be attempted, when possible. Here comes the role of TRAMB injection. We present a case of a man in his 70s, a known diabetic, who recovered from COVID-19 pneumonia but developed left-sided axial proptosis with orbital apex syndrome and ophthalmic artery occlusion secondary to rhino-orbital mucormycosis. The patient underwent debridement of paranasal sinuses and received intravenous liposomal amphotericin-B and three TRAMB injections. After three TRAMB injections significant improvement in extraocular movements, proptosis and ptosis was noted. An early intervention in orbital disease can avert a more radical procedure.<\/jats:p>","DOI":"10.1136\/bcr-2021-246307","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T12:20:28Z","timestamp":1648729228000},"page":"e246307","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Transcutaneous retrobulbar amphotericin-B (TRAMB) injection in orbital mucormycosis"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3589-8124","authenticated-orcid":false,"given":"Prabhakar","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhishek","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sravani Reddy","family":"Sanepalli","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Raj","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,3,31]]},"reference":[{"key":"2025082802560015000_15.3.e246307.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2021.05.019"},{"key":"2025082802560015000_15.3.e246307.2","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.4103\/ijo.IJO_1165_21","article-title":"Code Mucor: guidelines for the diagnosis, staging and management of Rhino-Orbito-Cerebral mucormycosis in the setting of COVID-19","volume":"69","author":"Honavar","year":"2021","journal-title":"Indian J Ophthalmol"},{"key":"2025082802560015000_15.3.e246307.3","doi-asserted-by":"publisher","DOI":"10.1097\/01.iop.0000225418.50441.ee"},{"key":"2025082802560015000_15.3.e246307.4","doi-asserted-by":"publisher","DOI":"10.1097\/IOP.0000000000000806"},{"key":"2025082802560015000_15.3.e246307.5","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3109\/01676830.2011.603596","article-title":"Orbital apergillosis treated with retrobulbar amphotericin B","volume":"31","author":"Mainville","year":"2012","journal-title":"Orbit"},{"key":"2025082802560015000_15.3.e246307.6","doi-asserted-by":"crossref","first-page":"100771","DOI":"10.1016\/j.ajoc.2020.100771","article-title":"Rhino-orbital-cerebral mucormycosis (ROCM) and associated cerebritis treated with adjuvant retrobulbar amphotericin B","volume":"19","author":"Safi","year":"2020","journal-title":"Am J Ophthalmol Case Rep"},{"key":"2025082802560015000_15.3.e246307.7","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1097\/ICU.0000000000000394","article-title":"Invasive fungal sinusitis: treatment of the orbit","volume":"28","author":"Kalin-Hajdu","year":"2017","journal-title":"Curr Opin Ophthalmol"},{"key":"2025082802560015000_15.3.e246307.8","article-title":"Outcomes of a modified treatment ladder algorithm using retrobulbar amphotericin B for invasive fungal rhino-orbital sinusitis","volume":"237","author":"Ashraf","year":"2021","journal-title":"Am J Ophthalmol"},{"key":"2025082802560015000_15.3.e246307.9","first-page":"1","article-title":"Transcutaneous retrobulbar injection of amphotericin B in rhino-orbital-cerebral mucormycosis: a review","author":"Nair","year":"2021","journal-title":"Orbit"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-246307","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:56:11Z","timestamp":1756374971000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-246307"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3]]},"references-count":9,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3,31]]},"published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1136\/bcr-2021-246307"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-246307","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,3]]}}}