Orbital Cellulitis Warrants Close Monitoring in Diabetes Patients

Pre-existing conditions such as chronic sinus issues and being on chronic steroid treatment raised the risk of a poor visual outcome with orbital cellulitis. Close monitoring is key. Photo: Anthony DeWilde, OD. Click image to enlarge. Patients with type 2 diabetes have a higher likelihood of experiencing aggressive infections. Given this fact, researchers at Drexel University College of Medicine in Philadelphia and the Wilmer Eye Institute at Johns Hopkins investigated whether this patient population experiences worse clinical outcomes after orbital cellulitis, an infection that can be vision- and life-threatening. Their findings, presented at the 2025 ARVO Annual Meeting in Salt Lake City, confirmed poorer visual outcomes in diabetic patients.The retrospective study analyzed data obtained from the TriNetX Research Network, including adult patients diagnosed with orbital cellulitis between 2004 and 2024 and excluding those with globe malformation or acquired anophthalmia. The study cohort included 5,202 patients with type 2 diabetes and a matched non-diabetic control group.The researchers reported that poor vision rates were significantly higher in diabetic patients compared with non-diabetic patients at three months and six months (7.5% of diabetic patients vs. 4.3% of non-diabetic patients at three months, and 7.8% and 4.6% at six months, respectively). Enucleation rates at three months were 0.7% and 0.5%, respectively. There were no additional enucleation cases at six months.Additionally, the researchers found that in diabetic patients, poor vision was associated with chronic sinusitis, neovascular glaucoma, glucocorticoid use and Zygomycosis. Enucleation was associated with Zygomycosis infection.The researchers concluded that higher rates of vision loss observed in type-2 diabetes patients with orbital cellulitis were “potentially due to increased susceptibility to severe infections.” They recommended careful management and follow-up for patients with these comorbidities.Original abstract content ©2025 Association for Research in Vision and Ophthalmology. Ealer C, Berkenstock M, Li E. Clinical outcomes of orbital cellulitis in the TriNetX database: a comparison of type 2 diabetic and non-diabetic adults. Abstract 2913-A0206. Presented at the 2025 ARVO Meeting in Salt Lake City, UT.