Half of ten cases of orbital aspergillosis occurred in patients in the fourth and fifth decades of life. In four cases, the orbit was secondarily involved, probably from direct extension from the paranasal sinuses. Of five patients who had brain involvement, the primary focus of infection in two was "apparently intracranial," while in three there was secondary involvement of the central nervous system. No evidence of systemic fungal disease was found. The disease presented a protracted clinical course with poor response to local excision of involved tissues and antifungal agents. Six patients are known to have died of the disease; the other four were lost to follow-up. Species of Aspergillus was cultured in four cases. A review of the literature disclosed only 20 previously reported cases.
Green WR, Font RL, Zimmerman LE. Aspergillosis of the OrbitReport of Ten Cases and Review of the Literature. Arch Ophthalmol. 1969;82(3):302-313. doi:10.1001/archopht.1969.00990020304002