MONDAY, Feb. 23, 2026 (HealthDay News) -- Clinical features and outcomes of injection drug use-associated endogenous endophthalmitis (IDU-EE) are described in a study published online Jan. 13 in Ophthalmology Retina.
Jared T. Sokol, M.D., from the University of Colorado School of Medicine in Aurora, and colleagues conducted a retrospective cohort study involving 62 patients (65 eyes) diagnosed with IDU-EE to identify influential factors and opportunities for intervention.
The researchers report that initial ophthalmic treatments were tap-and-inject (TAI) and pars plana vitrectomy (PPV) with intravitreal antimicrobials in 51 and nine eyes (78.5 and 13.8 percent, respectively). In 30 eyes (46.2 percent), subsequent PPV was performed. In 34 eyes (54.8 percent), intraocular cultures were positive. Compared with PPV, TAI was less likely to yield a positive culture (11/52 versus 26/39). There was an improvement seen in the median visual acuity (VA) from 1.30 to 0.48 logarithm of the minimum angle of resolution at presentation and at most recent follow-up, respectively; in 43 eyes (68.2 percent), VA improved. Fifteen eyes (23.1 percent) had retinal detachment. Final VA was not influenced by initial TAI versus PPV. The odds of off-chart (less than or equal to counting fingers) VA outcome at the most recent follow-up were increased with reported fentanyl use (odds ratio, 5.25). Thirty-seven (68.5 percent) of the 54 patients who were admitted saw the addiction consult service (ACS) while hospitalized; all eligible patients who saw the ACS were offered a medication for opioid use disorder (MOUD) and 13 of these 24 accepted a new MOUD.
"This study reinforces that eye doctors can offer much more to patients than vision care alone," coauthors Eric Gaier, M.D., Ph.D., and Dean Eliott, M.D., from Harvard Medical School and Massachusetts Eye and Ear in Boston, said in a statement. "For patients with injection drug use-related infections, an ophthalmology visit may be one of the few times they engage with the health care system. Ensuring that addiction consult services are involved through these encounters can directly impact these individuals’ survival, not just their sight."
Two authors disclosed ties to the biopharmaceutical industry.