Original articleIntravenous Drug Use–Associated Endophthalmitis
Section snippets
Methods
Institutional Review Board approval was obtained by the Human Studies Committee and the study protocol adhered to the Declaration of Helsinki. International Classification of Diseases 9 (ICD-9) billing codes were used to identify cases of endophthalmitis at the Massachusetts Eye and Ear Infirmary (MEEI) from September 2006 until November 2014. Every medical record was reviewed and patients with a preceding history of IVDU were identified.
Inclusion criteria included a history of endophthalmitis,
Patient Characteristics
A total of 338 patients with endophthalmitis were seen during the study period, of which 68 had endogenous endophthalmitis (20%), and 30 patients (32 eyes) were identified as having IVDU-associated endophthalmitis (9% of total, 44% of endogenous cases). There were 36 patients (36 eyes) with non-IVDU endogenous endophthalmitis. One patient did not have visual acuity data available for analysis because presentation preceded electronic medical records. Mean follow-up time was 11 months (range, 1
Discussion
This is the largest series of IVDU-associated endophthalmitis to date. IVDU-associated endophthalmitis is a significant source of ophthalmic morbidity, accounting for 9% of all cases of endophthalmitis at our academic referral center. Ten patients were initially misdiagnosed before presentation. Patients with IVDU-associated endophthalmitis are typically young and with minimal systemic complaints. These patients may be initially reluctant to volunteer a history of drug use; however, clinicians
References (27)
Endophthalmitis
Clin Microbiol Infec
(2013)- et al.
Endogenous endophthalmitis caused by Candida albicans in a healthy woman
Am J Ophthalmol
(1992) - et al.
Culture-proven endogenous endophthalmitis: clinical features and visual acuity outcomes
Am J Ophthalmol
(2004) - et al.
Fungal eye disease at a tertiary care center: the utility of routine inpatient consultation
Ophthalmology
(2011) - et al.
Endogenous bacterial endophthalmitis: an east Asian experience and a reappraisal of a severe ocular affliction
Ophthalmology
(2000) Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers—United States, 2002–2004 and 2008–2010
Drug Alcohol Depend
(2013)- et al.
Endogenous bacterial endophthalmitis: a 17-year prospective series and review of 267 reported cases
Surv Ophthalmol
(2003) - et al.
[Endogenous Candida endophthalmitis in drug misusers injecting intravenous buprenorphine]
J Fr Ophtalmol
(2008) - et al.
Endogenous Aspergillus endophthalmitis in a healthy individual
Nepal J Ophthalmol
(2012) - et al.
Endogenous Aspergillus endophthalmitis in an immunocompetent individual
Int Ophthalmol
(1993)
Endogenous endophthalmitis: a 13-year review at a tertiary hospital in South Australia
Scand J Infect Dis
Fungal endophthalmitis: fourteen years' experience from a center in India
Retina
Endogenous endophthalmitis associated with intravenous drug abuse: seven-year experience at a tertiary referral center
Retina
Cited by (0)
Financial Disclosure(s): The author(s) have made the following disclosure(s): There were no funding sources for this project. The authors have no conflicts of interest to report. B.S.M., A.V.F., T.D.P., M.D., D.H.: No financial disclosures. D.E.: Consultant — Alcon, Alimera, Allergan, Arctic, Avalanche, Dutch Ophthalmic, Ophthotech, MacuLogix, Santen, and Thrombogenics; Research grants — Neurotech and Ocata Therapeutics.
Author Contributions:
Research design: Modjtahedi, Finn, Papakostas, Husain, Eliott
Data analysis and/or interpretation: All authors (Modjtahedi, Finn, Papakostas, Durand, Husain, Eliott)
Data acquisition and/or research execution: All authors (Modjtahedi, Finn, Papakostas, Durand, Husain, Eliott)
Manuscript preparation: All authors (Modjtahedi, Finn, Papakostas, Durand, Husain, Eliott)
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Drs Modjtahedi and Finn contributed equally to this work.