Dose adjustment of intravitreal medications and gases according to axial length and vitreous cavity volume.

IF 1.2 4区医学 Q3 OPHTHALMOLOGY

Arquivos brasileiros de oftalmologia Pub Date : 2025-10-10 eCollection Date: 2025-01-01 DOI:10.5935/0004-2749.2025-0077

Rodrigo Pessoa Cavalcanti Lira, Ana Paula Teles Silveira, Gabriel Rocha Lira, Maria Isabel Lynch Gaete

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引用次数: 0

Abstract

Purpose: Standard intravitreal medication dosages are based on an assumed vitreous cavity volume of 4.0-4.5 mL. However, individual variations in vitreous cavity volume may influence both the efficacy and safety of these medications. This study proposes dosage adjustments for intravitreal medications and gases according to axial length and the corresponding vitreous cavity volume.

Methods: This descriptive study employed reference guidelines that use axial length to estimate the Axial Length-based Volume of the Vitrectomized Space and the Vitreous Volume EXact table for determining dose adjustments across varying eye sizes. Small eyes (axial length 19-22 mm) have an average vitreous cavity volume of 3.5 mL at an axial length of 20.5 mm; standard-sized eyes (22-25 mm) have 4.8 mL at 23.5 mm; large eyes (25-28 mm) have 6.4 mL at 26.5 mm; and extra-large eyes (28-32 mm) have 8.4 mL at 29.5 mm. The medications considered included anti-infectives, anti-VEGFs, complement inhibitors, recombinant proteases, chemotherapy agents, corticosteroids, and medical gases.

Results: Analysis of intravitreal drug concentrations relative to vitreous cavity volume demonstrated notable variability when a standard dose was administered. Small eyes received about 135% of the concentration intended for a standard-sized eye; large eyes received around 75%; and extra-large eyes received under 60%. The recommended dose adjustments are as follows: for small eyes, administer 70-80% of the standard dose; for large eyes, 130-140%; and for extra-large eyes, 170-180%.

Conclusions: Tailoring intravitreal drug and gas dosages according to axial length and vitreous cavity volume may enhance intraocular drug distribution, potentially improving both safety and therapeutic outcomes.

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根据轴长和玻璃体腔体积调整玻璃体内药物和气体的剂量。

目的：标准玻璃体内给药剂量是基于假定的玻璃体腔容积为4.0-4.5 mL。然而，玻璃体腔容积的个体差异可能会影响这些药物的疗效和安全性。本研究建议根据轴向长度和相应的玻璃体腔体积调整玻璃体内药物和气体的剂量。方法：本描述性研究采用参考指南，使用轴向长度来估计基于轴向长度的玻璃体切割空间体积，并使用玻璃体体积精确表来确定不同眼睛大小的剂量调整。小眼（眼轴长19-22 mm）在眼轴长20.5 mm处，平均玻璃腔体积为3.5 mL；标准尺寸的眼睛（22-25毫米）在23.5毫米处有4.8毫升；大眼睛（25-28毫米）在26.5毫米处有6.4毫升；而特大眼（28-32毫米）在29.5毫米处有8.4毫升。考虑的药物包括抗感染、抗vegf、补体抑制剂、重组蛋白酶、化疗药物、皮质类固醇和医用气体。结果：玻璃体内药物浓度相对于玻璃腔体积的分析显示，当给予标准剂量时，有显著的变异性。小眼睛接受的浓度约为标准尺寸眼睛的135%；大眼睛约占75%；超大眼睛的比例低于60%。建议剂量调整如下：对于小眼睛，给予标准剂量的70-80%；对于大眼睛，130-140%；对于超大的眼睛，则是170-180%。结论：根据眼轴长度和玻璃体腔体积调整玻璃体内药物和气体剂量可增强眼内药物分布，有可能改善安全性和治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arquivos brasileiros de oftalmologia OPHTHALMOLOGY-

CiteScore

1.60

自引率

0.00%

发文量

200

审稿时长

6-12 weeks

期刊介绍： The ABO-ARQUIVOS BRASILEIROS DE OFTALMOLOGIA (ABO, ISSN 0004-2749 - print and ISSN 1678-2925 - (ABO, ISSN 0004-2749 - print and ISSN 1678-2925 - electronic version), the official bimonthly publication of the Brazilian Council of Ophthalmology (CBO), aims to disseminate scientific studies in Ophthalmology, Visual Science and Health public, by promoting research, improvement and updating of professionals related to the field.