ENDOGENOUS ENDOPHTHALMITIS ASSOCIATED WITH INJECTION DRUG USE COMPARED WITH OTHER ETIOLOGIES.

Area of Science:

• Ophthalmology
• Infectious Diseases
• Public Health

Background:

• Endogenous endophthalmitis is a severe intraocular infection.
• Injection drug use (IDU) is a known risk factor for various infections, including endophthalmitis.

Purpose of the Study:

• To compare the clinical features of endogenous endophthalmitis in patients with a history of injection drug use (IDU) versus those with other causes.
• To identify unique characteristics of IDU-associated endophthalmitis for improved diagnosis and management.

Main Methods:

• Retrospective data collection from three academic tertiary care centers over six years.
• Comparison of presenting characteristics, microbiological findings, treatment, and visual acuity between IDU and non-IDU endogenous endophthalmitis groups.

Main Results:

• IDU patients were younger, more frequently male, and had longer symptom duration compared to non-IDU patients.
• IDU group showed significantly lower rates of identified systemic infection sources (29% vs. 71%) and positive cultures (47% vs. 80%).
• IDU patients were less likely to be hospitalized or receive intravenous antimicrobial treatment, with no significant difference in final visual acuity.

Conclusions:

• Endogenous endophthalmitis in IDU patients often presents with fewer comorbidities and lacks positive cultures or a clear systemic source.
• A high index of suspicion is crucial for diagnosing IDU-related endophthalmitis due to its distinct presentation.