[Bilateral candida endophthalmitis in 2 i. v. drug-dependent patients with oral L-methadone substitution]

Controlled therapy programs for former i.v. heroin abusers supervised by physicians offer levomethadone (L-Polamidon) as an oral substitute for heroin to allow social stabilisation of the addict. As well they reduce the risk of bloodborne infections (e.g. HIV and hepatitis) by giving up "needle sharing". Assuming that i.v. drug abuse is one of the major risk factors for Candida endophthalmitis in young, otherwise healthy patients, in case of strict oral substitution no onset of Candida endophthalmitis should be expected.

The clinical courses of two HIV-negative and primarily i.v. heroin addicted young male white patients are presented. While participating in an exclusively controlled, oral program of methadone substitution for several months, both patients developed bilateral Candida endophthalmitis.

A persisting i.v. abuse, either of heroin or of L-methadone, parallel to the supposingly strict orally applied substituting drug L-methadone has definitely to be suspected leading to the Candida endophthalmitis.