Method and device for intravitreous volume calculation

Abstract

The invention relates to a method for determination of the vitreous volume of an eye, in particular an eye of a mammal, such as a human eye, the method comprising the following steps: - measuring the axial length of the eye; - applying the measured axial length to equation (II): V = (X * AL3 + Y * AL4) wherein: AL is the measured axial length of the eye in millimeters; X has a value of between 0.200 and 0.300; Y has a value of between 0.0050 and 0.0080; V is the vitreous volume V of the eye in mm3; obtaining or outputting the vitreous volume of the eye as the calculation result of equation (II). The invention also relates to a computer-readable medium, a computer program product, a device, and a kit.

Description

[0001] 64381 / MB

[0002] Method and device for intravitreous volume calculation

[0003] The present invention relates to different aspects, such as a method and a device for calculation of the intravitreous volume of an eye, in particular an eye of a mammal.

[0004] The vitreous humor is a transparent, hydrophilic, gel-like structure situated in the posterior segment of the eye, occupying approximately 80% of the eye’s volume and filling the space known as the vitreous chamber, which lies between the lens and the retina. It helps in maintaining the transparency and structure of the eye. Its main component is water (99%). Other components include salts, sugars, vitrosin, and proteins. The inorganic ion content of vitreous includes sodium, potassium, chloride, calcium, magnesium, bicarbonate, and phosphate. The inorganic coenzymes in the vitreous humor are manganese, iron, copper, and selenium. Immunoglobulins (particularly IgG) and cells are also present in the vitreous humor. Hyalocytes (vitreous cells) are present in the vitreous humor and produce hyaluronic acid and collagen.

[0005] In books such as the well-known almanac “Pathology of the Eye” by Naumann GOH and Apple DJ, the vitreous body is described as follows: “A transparent gelatinous mass, the vitreous body fills the space between the lens, ciliary body and retina, which holds about 4,000 mm3(= two-thirds of the bulb volume). It is devoid of vessels and nerves and consists of 99% water. The entire vitreous body is permeated by a uniformly 64381 / MB structured collagen fiber scaffold. The collagen framework is denser in the periphery and more circularly oriented (vitreous cortex). The central vitreous has fewer fibrils and more fluid than the cortex. The basic substance between the vitreous fibrils is an amorphous, semi-fluid, viscous mass in which abundant hyaluronic acid is dissolved” [1 , 2].

[0006] The spherical eyeball weighs about 6.5-7.5 g. However, this range may be much larger in individual cases. In an emmetropic adult, the eyeball has an average axial diameter of 23-24 mm. Regarding the volume of the vitreous, in most published books and in literature, only approximate values are given: “The volume of the vitreous in an adult eye is around 4,000 mm3.” This specification seems to be relatively inaccurate.

[0007] In the past, several authors have discussed the correlation between eye length and anterior chamber depth and the size of the vitreous cavity [3, 4], It seems very unusual that in ophthalmology, dealing with intravitreous injections, so-called intravitreous surgical drug applications (IVOMs), only standard doses are given and they are not individually adjusted. Currently, one dose with the same amount is injected into all patients’ vitreous, regardless of anatomical conditions. This is in strong contrast to other parts of medicine and subspecialties, thinking of infusions, injections, or even oral therapies - each with a dose adapted to volume or matched to quantity or weight. The benefits of tailored patient dosing and personalized medicine are proven and safety and efficacy are described by thousands of clinical studies. The motto and regime: “As much as necessary, as little as possible” is widely spread and has proven itself.

[0008] It is therefore an object of the present invention to at least partly overcome these drawbacks in relation to current practice in intravitreous therapy.

[0009] In an extensive study, the present inventors have determined the size relationships of the vitreous cavity more precisely to analyze differences between small, hypermetropic and large, myopic eyes regarding vitreous body volume. It has been found that the intravitreous volume of different patients’ eyes vary widely, namely in a range of between 3,000 mm3and 10,000 mm3. 64381 / MB

[0010] This finding highlights the importance of individual dose adjustment of intravitreous medication.

[0011] Within this study, it has now been surprisingly found that the intravitreous volume of an eye can be calculated solely based on the knowledge of the axial length of the eye and considering a specific correction factor, which takes into account the portion of the vitreous in the entire globe and the proportional increase of the vitreous portion for long (myopic) eyes.

[0012] The knowledge of the vitreous volume can be used to adjust the amount of intravitreous medication or other agents administered to the vitreous cavity individually to the size of an eyeball, assuming that the individual dosing suggestion was made based on the standard vitreous volume of between 4,000 mm3and 5,000 mm3, and a normal axial length of between 22.5 mm and 23.5 mm.

[0013] The present invention now applies this finding to different aspects, such as:

[0014] - a method for the determination of the vitreous volume, which can be for example a computer-implemented method;

[0015] - a device for the determination of the vitreous volume, which is adapted to measure the axial length of an eye and subsequently calculate the vitreous volume;

[0016] - a method for the determination of the amount of agent administered to an eye, taking into account its vitreous volume.

[0017] In particular, the inventors have found a correlation between the axial length of the eye and the vitreous volume according to equation (I) below: equation (I) wherein AL is the measured axial length of the eye in millimeters; P is a correction factor, which relates to the portion of the vitreous in the entire globe; Q is a correction factor to account for the proportional increase of the vitreous portion for myopic eyes; R relates to a typical length of emmetropic eyes. 64381 / MB

[0018] The result V is the vitreous volume of the eye in mm3, or an estimate for the vitreous volume of the eye in mm3. The input of the axial length should also be in mm.

[0019] Equation (I) can be simplified to equation (II) below: equation (II) wherein the factors X and Y combine two or more of the factors I constants of equation (!)■

[0020] Equation (II) is particularly usable, if the axial length of the eye is between 15.0 mm and 35.0 mm, such as in between 18.0 mm and 30.0 mm.

[0021] It has been found that the factors X and Y allow for some variations, while still yielding acceptable calculation results, which differ only insignificantly from actually measured vitreous volumes. The term “differ insignificantly” may in this respect relate to variations of 15% or less, such as 10% or less, preferably 5% or less.

[0022] Thus, in certain embodiments, one or more of the following may be provided:

[0023] - X has a value of between 0.210 and 0.290,

[0024] - X has a value of between 0.230 and 0.270,

[0025] - X has a value of between 0.235 and 0.260,

[0026] - X has a value of between 0.240 and 0.250,

[0027] - Y has a value of between 0.0050 and 0.0075,

[0028] - Y has a value of between 0.0055 and 0.0070,

[0029] - Y has a value of between 0.0058 and 0.0067,

[0030] - Y has a value of between 0.0060 and 0.0065.

[0031] Equation (II) can be used in different aspects of the invention. The result of the equation, i.e., the calculated vitreous volume, can be used as direct output, and / or it can be used for further calculations, such as for dose adjustment calculations. 64381 / MB

[0032] In one aspect of the invention, the method, in which equation (II) is used, is a computer- implemented method. However, information derived from equation (II) may also be used in any other way, such as on a display device, such as a printed chart, where a multitude of different axial lengths are shown vis a vis the respective vitreous volume calculated using equation (II).

[0033] Equation (II) may also be implemented in a device, which processes the measured values of the axial length. Said device may also include a measurement device for determining the axial length, but the axial length may also be measured using an external device.

[0034] The invention may also encompass a computer-readable medium and / or a computer program product, which contain computational instructions that implement equation (II).

[0035] As mentioned above, the findings of the invention may also be used for dose adjustment of intravitreous medication. The invention therefore extends to a method for determining an adjusted dose of an intravitreous medication and / or therapeutic agent using a correction factor. Said correction factor may be determined from the vitreous volume as calculated by equation (II) relative to the typical vitreous volume of an eye, in particular an eye of a mammal, such as a human eye, which may be in between 4.000 mm3and 5.500 mm3.

[0036] The invention can also be employed for the determination of the amount of another agent administered to the vitreous cavity, such as an intravitreous tamponade (e.g., gas or silicone oil) or artificial vitreous, and intravitreous medication.

[0037] Another aspect of the invention may therefore relate to a kit, containing at least: an agent, such as intravitreous medication, an intravitreal tamponade or artificial vitreous; instructions for the determination of the amount of the agent administered to a patient based on the vitreous volume as calculated by equation (II). 64381 / MB

[0038] The invention may relate to a method for determination of the vitreous volume of an eye, in particular an eye of a mammal, such as a human eye, the method comprising the following steps:

[0039] - measuring the axial length of the eye,

[0040] - applying the measured axial length to equation (II) equation (II) wherein: AL is the measured axial length of the eye in millimeters; X has a value of between 0.200 and 0.300; Y has a value of between 0.0050 and 0.0080; V is the vitreous volume V of the eye in mm3;

[0041] - obtaining or outputting the vitreous volume of the eye as the calculation result of equation (II).

[0042] It may be provided that equation (II) is replaced by equation (I): equation (I) wherein: AL designates the axial length of the eye, V is the vitreous volume in mm3; P is 0.76; Q is 0.012; R is 24.

[0043] It may be provided that the axial length AL is measured using a biometric device.

[0044] It may be provided that the axial length AL has a value between 15.0 mm and 35.0 mm, such as between 18.0 mm and 30.0 mm.

[0045] It may be provided that in equation (II), X has a value of between 0.210 and 0.290, such as in between 0.230 and 0.270 and / or wherein in equation (II), Y has a value of between 0.0050 and 0.0075, such as in between 0.0055 and 0.0070.

[0046] It may be provided that in equation (II), X has a value of between 0.235 and 0.260, such as in between 0.240 and 0.250 and / or wherein in equation (II), Y has a value of between 0.0058 and 0.0067, such as in between 0.0060 and 0.0065.

[0047] It may be provided that the method is a computer-implemented method, wherein: the measured axial length is sent to a processing device using a communication means; calculation is performed using the data processing device, such as a computer; the 64381 / MB obtained calculation result of equation (II) is sent to an output device using a communication means; and the vitreous volume is received and optionally displayed by the output device.

[0048] The invention may relate to a computer-readable medium comprising instructions which, when executed by a computer, cause the computer to carry out at least some of the steps of the method.

[0049] The invention may relate to a computer program product comprising instructions which, when the program is executed by a computer, cause the computer to carry out at least some of the steps of the method.

[0050] The invention may relate to a device comprising:

[0051] - a measurement device, adapted for measuring the axial length AL of an eye, in particular an eye of a mammal, such as a human eye,

[0052] - a processing device adapted for processing the measured axial length AL using equation (II) equation (II) wherein: AL is the measured axial length of the eye in millimeters; X has a value of between 0.200 and 0.300; Y has a value of between 0.0050 and 0.0080; V is the vitreous volume V of the eye in mm3;

[0053] - an output device for outputting the vitreous volume V of the eye as determined by equation (II).

[0054] It may be provided that the measurement device is a biometric device.

[0055] The invention may relate to a method for determining the amount of an agent to be administered into the vitreous cavity of an eye, in particular an eye of a mammal, such as a human eye, comprising the following steps:

[0056] - calculating the vitreous volume V of the eye using a method as described herein;

[0057] - providing an amount of agent to be administered to the eye based on the calculated vitreous volume V. 64381 / MB

[0058] It may be provided that a correction value CV in accordance with equation (III) is calculated

[0059] V

[0060] CV = - - equation (III)

[0061] ''norm wherein Vnorm has a value of between 4.000 mm3and 5.500 mm3, and wherein the amount of agent to be administered to the eye is determined based on the correction value CV.

[0062] It may be provided that the amount of agent to be administered to the eye is between 90% to 110%, such as between 95% to 105%, of the calculated vitreous volume V.

[0063] It may be provided that the agent is a medication containing at least one therapeutically active ingredient and / or wherein the agent is artificial vitreous and / or wherein the agent is an intravitreal tamponade.

[0064] It may be provided that the therapeutically active ingredient is selected of one or more from the following: an antibody-based agent, such as an anti-vascular endothelial growth factor; a glucocorticoid; an anti-bacterial agent; and anti-fungal agent; a virostatic agent; a cytostatic agent; an anti-inflammatory agent; a nanoparticle-based medicinal agent; a stem cell-containing agent; a protease; a complement inhibitor; a narcotic agent; an anesthetic agent.

[0065] It may be provided that the intravitreal tamponade is selected of one or more from the following: a gas, such as SFe, or a fluorinated alkane; silicone oil.

[0066] Knowledge of the vitreous volume may also be used to adjust the size of so-called scleral buckles.

[0067] It may be provided that the artificial vitreous is a hydrogel, such as a hyaluronic acid hydrogel.

[0068] It may be provided that the active ingredient is selected from one or more of the following: triamcinolone acetonide; aflibercept; bevacizumab; brolucizumab; ranibizumab; dexamethasone; faricimab; ganciclovir; clindamycin; foscarnet; fomivirsen; 64381 / MB methotrexate; vancomycin; ceftazidime; amikacin; amphotericin; voriconazole; pegcetacoplan, ocriplasmin.

[0069] It may be provided that the therapeutically active ingredient is present as a sustained- release formulation, or that the therapeutically active ingredient is contained in a drugeluting implant.

[0070] The invention may relate to a kit comprising:

[0071] - an agent for intravitreous administration, and

[0072] - instructions for determining the amount of agent to be administered based on the vitreous volume of a patient’s eye, wherein the vitreous volume is determined by equation (II) equation (II) wherein: AL is the measured axial length of the eye in millimeters; X has a value of between 0.200 and 0.300; Y has a value of between 0.0050 and 0.0080; V is the vitreous volume V of the eye in mm3;

[0073] It may be provided that the agent is a medication containing at least one therapeutically active ingredient and / or wherein the agent is artificial vitreous and / or wherein the agent is a intravitreal tamponade.

[0074] It may be provided that the therapeutically active ingredient is selected of one or more from the following: an antibody-based agent, such as an anti-vascular endothelial growth factor; a glucocorticoid; an anti-bacterial agent; and anti-fungal agent; a virostatic agent; a cytostatic agent; an anti-inflammatory agent; a nanoparticle-based medicinal agent; a stem cell-containing agent; a protease; a complement inhibitor; a narcotic agent; an anesthetic agent.

[0075] It may be provided that the intravitreal tamponade is selected of one or more from the following: a gas, such as SFe, or a fluorinated alkane; silicone oil.

[0076] It may be provided that the artificial vitreous is a hydrogel, such as a hyaluronic acid hydrogel. 64381 / MB

[0077] It may be provided that the therapeutically active ingredient is selected from one or more of the following: triamcinolone acetonide; aflibercept; bevacizumab; brolucizumab; ranibizumab; dexamethasone; faricimab; ganciclovir; clindamycin; foscarnet; fomivirsen; methotrexate; vancomycin; ceftazidime; amikacin; amphotericin; voriconazole; pegcetacoplan, ocriplasmin.

[0078] It may be provided that the agent is contained in a pre-filled syringe.

[0079] It may be provided that the therapeutically active ingredient is present as a sustained- release formulation, or that the therapeutically active ingredient is contained in a drugeluting implant.

[0080] Further aspects of the invention will become apparent to a person skilled in the art from the following description of exemplary embodiments. The features and details given below are in no way intended to limit the scope of protection, which is solely defined by the claims.

[0081] Methods and patient data

[0082] In a retrospective observational study, patients were included who had undergone magnetic resonance imaging (MRI) of the orbit or skull in the previous 12 months. The reasons for MRIs were diverse, including neurological disorders like multiple sclerosis, chronic headache, migraine, follow-up of tumors in the brain, follow-up of injuries and strokes, or hemorrhages within the brain. Inclusion criteria were high-quality imaging of the eye and an MR device with good resolution of at least 3 Tesla. For the study, no additional MRIs were performed; only pre-existing findings and images of the patients were analyzed. Patients who had MR images due to injuries of the eye such as perforating eyeball injuries or tumors of the eye were excluded. Patients aged under 25 years or MRIs older than 12 months were excluded. All procedures performed in studies involving human participants were in accordance with the ethical standards and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The local ethics committee (IRB) has provided a waiver for this study (Arztekammer des 64381 / MB

[0083] Saarlandes, 157 / 21 ), as all data processed in this study were already anonymized at the source before being transferred to processing. This precludes any back-tracing of the identity, and therefore informed consent of the patients was not necessary. Table Tablel shows the demographics of the included individuals.

[0084] Table 1: Demographics of the included patients (72 eyes of 36 patients in three groups)

[0085] Biometric data of the eye including measurements of the anterior chamber and the overall axial length of the eyeball were analyzed using IOL Master 500 (Carl Zeiss Meditec, Germany) and Pentacam AXL (Oculus, Germany). The data were divided regarding axial length measurements into three groups: Emmetropes (n = 28), myopes (n = 24), and hypermetropes (n = 20). Table 2 shows the refraction and biometric measurements including axial length and anterior chamber depth.

[0086] Table 2 - Measurement data of 72 eyes from 36 patients 64381 / MB 64381 / MB interior chamber depth (ACD) (in mm)

[0087] Refraction (sphere / cylinder / axis)

[0088] 4three groups: emmetropic eyes (E), myopic eyes (M) and hyperopic eyes (H)

[0089] Determination of correction term 64381 / MB

[0090] Based on the volume of a sphere with the diameter of the axial length (AL), which shows a volume of AL3TT / 6, a correction term of 0.76 +[ 0.012 x (AL-24)] was derived in this exemplary embodiment, to account for the portion of the vitreous in the entire globe and the proportional increase of the vitreous portion for long (myopic) eyes. This correction was developed based on the analysis of the MR images of emmetropic, myopic, and hypermetropic eyes. 3D-reconstructions of eyeballs were prepared to compare the dimensions.

[0091] The vitreous volume of all cases can be calculated using the following equation (I): equation (I) wherein AL designates the axial length of the eye, determined by biometry as described above and V is the vitreous volume in mm3. In this exemplary embodiment, P is 0.76; Q is 0.012; R is 24. It should be appreciated that certain variations of these parameters are possible, without significantly impairing the accuracy of the calculation results.

[0092] The calculation results show wide differences in myopic and hypermetropic eyes in a range of 3,000-10,000 mm3as compared to emmetropic eyes with a volume of between 4,000-5,500 mm3. For example, the volume is approx, twice as large in a myopic case and approx. 1 / 3 less in a hypermetropic case compared to the typical emmetropic eye.

[0093] Application of the calculation results for dose adjustment

[0094] In this example, a correction table has been prepared to easily and quickly obtain the individual vitreous volume. This table can be a printed chart, which shows axial lengths between 18.0 mm and 30.0 mm along with the corresponding vitreous volumes as determined by equation (II). In an alternative example, the calculation of the vitreous volume can be performed using a computer or another suitable calculation device, using the axial length as input value. Said table or the computed results can be used for dose adjustment of intravitreous medication. 64381 / MB

[0095] If one assumes that the intravitreous medication was originally planned for the standard vitreous volume of 4,000-5,000 mm3and a normal axial length of 22.5-23.5 mm, it can be adapted individually to the sizing of the eyeball to avoid under- or overtreatment. Table 3 shows the assumed required amount of active ingredient in mg assuming that the recommended dose applies to an average vitreous volume (VV) of 4,000 mm3.

[0096] Table 3: Assumed required amount of active ingredient in mg or amount of ready-to-use injection solution in pL

[0097] Using the calculation results of the vitreous volume, dose adjustment can be performed.

[0098] Example - Kit

[0099] In an exemplary embodiment, the invention relates to a kit, as described herein. The kit of this embodiment contains a dose of an intravitreous medication, which is adapted for a vitreous volume of 4,500 mm3. The kit further contains instructions how to determine the actual vitreous volume of a specific patient’s eye and adjust the dose of medication based thereon.

[0100] The instructions may be in the form of a printed table, which is part of the kit. This table may show a multitude of axial lengths, such as in steps if 0.5 mm or 1 .0 mm from 18.0 mm up to 30.0 mm, each correlated with the vitreous volume as determined by equation (II). As an alternative, the vitreous volume may be replaced by a correction factor or an amount specific for the intravitreous medication. 64381 / MB

[0101] Example - Computer implemented method

[0102] As mentioned already, the calculation can be performed as a computer implemented method. A scheme of such method is illustrated in Fig. 1 . The axial length of an eye is measured using a biometric device 1 , where after the measurement result is transmitted to a data processing unit 2, which applies equation (II) to the measurement result. The result, namely the vitreous volume as calculated by the equation is then sent to a display device 3, which outputs the result to be used further.

[0103] References

[0104]

[0001] Naumann GOH, Apple DJ. Pathology of the eye. Springer New York; 1986.

[0105] [2] Scott JE. The chemical morphology of the vitreous. Eye (Lond) 1992;6(Pt 6):553- 555. doi: 10.1038 / eye.1992.120.

[0106] [3] Kim SY, Cho SY, Yang JW, Kim CS, Lee YC. The correlation of differences in the ocular component values with the degree of myopic anisometropia. Korean J Ophthalmol. 2013;27(1):44-47. doi: 10.3341 / kjo.2013.27.1 .44.

[0107] [4] Chen Y, Wang D, Chen L, Yan W, He M. Association of refraction and ocular biometry in highly myopic eyes. Clin Exp Optom. 2021 ;104(5):589-594. doi: 10.1080 / 08164622.2021 .1878819.

Claims

64381 / MBClaims1 . A method for determination of the vitreous volume of an eye, in particular an eye of a mammal, such as a human eye, the method comprising the following steps: a. measuring the axial length of the eye, b. applying the measured axial length to equation (II)equation (II) wherein: AL is the measured axial length of the eye in millimeters; X has a value of between 0.200 and 0.300; Y has a value of between 0.0050 and 0.0080; V is the vitreous volume V of the eye in mm3; c. obtaining or outputting the vitreous volume of the eye as the calculation result of equation (II).

2. The method according to claim 1 , wherein equation (II) is replaced by equation (I): equation (I)wherein: AL designates the axial length of the eye, V is the vitreous volume in mm3; P is 0.76; Q is 0.012; R is 24.

3. The method according to claim 1 or 2, wherein the axial length AL is measured using a biometric device.

4. The method according to any of claims 1 to 3, wherein the axial length AL has a value between 15.0 mm and 35.0 mm, such as between 18.0 mm and 30.0 mm.

5. The method according to any of claims 1 or 3 to 4, wherein in equation (II), X has a value of between 0.210 and 0.290, such as in between 0.230 and 0.270 and / or wherein in equation (II), Y has a value of between 0.0050 and 0.0075, such as in between 0.0055 and 0.0070.64381 / MB6. The method according to any of claims 1 or 3 to 5, wherein in equation (II), X has a value of between 0.235 and 0.260, such as in between 0.240 and 0.250 and / or wherein in equation (II), Y has a value of between 0.0058 and 0.0067, such as in between 0.0060 and 0.0065.

7. The method according to any of claims 1 to 6, wherein the method is a computer- implemented method, wherein:- the measured axial length is sent to a processing device using a communication means;- at least step (b) is performed using the data processing device, such as a computer;- the obtained calculation result of equation (II) is sent to an output device using a communication means; and- the vitreous volume is received and optionally displayed by the output device.

8. A computer-readable medium comprising instructions which, when executed by a computer, cause the computer to carry out at least steps (b) and (c) of the method of claims 1 to 7.

9. A computer program product comprising instructions which, when the program is executed by a computer, cause the computer to carry out at least steps (b) and (c) of the method of claims 1 to 7.

10. A device comprising: a. a measurement device, adapted for measuring the axial length AL of an eye, in particular an eye of a mammal, such as a human eye, b. a processing device adapted for processing the measured axial length AL using equation (II)equation (II) wherein: AL is the measured axial length of the eye in millimeters; X has a value of between 0.200 and 0.300; Y has a value of between 0.0050 and 0.0080; V is the vitreous volume V of the eye in mm3;64381 / MB c. an output device for outputting the vitreous volume V of the eye as determined by equation (II).1 1 . The device according to claim 10, wherein the measurement device is a biometric device.

12. A method for determining the amount of an agent to be administered to the vitreous cavity of an eye, in particular an eye of a mammal, such as a human eye, comprising the following steps: a. calculating the vitreous volume V of the eye using a method according to any of claims 1 to 7; b. providing an amount of agent to be administered to the eye based on the calculated vitreous volume V.

13. The method according to claim 12, wherein a correction value CV in accordance with equation (III) is calculatedVCV = - - equation (III)''norm wherein Vnorm has a value of between 4.000 mm3and 5.500 mm3, and wherein the amount of agent to be administered to the eye is determined based on the correction value CV.

14. The method according to claim 12, wherein the amount of agent to be administered to the eye is between 90% to 1 10%, such as between 95% to 105%, of the calculated vitreous volume V.

15. The method according to any of claims 12 to 14, wherein the agent is a medication containing at least one therapeutically active ingredient and / or wherein the agent is artificial vitreous and / or wherein the agent is an intravitreal tamponade.64381 / MB16. The method according to claim 15,- wherein the therapeutically active ingredient is selected of one or more from the following: an antibody-based agent, such as an anti-vascular endothelial growth factor; a glucocorticoid; an anti-bacterial agent; and anti-fungal agent; a virostatic agent; a cytostatic agent; an anti-inflammatory agent; a nanoparticle-based medicinal agent; a stem cell-containing agent; a protease; a complement inhibitor; a narcotic agent; an anesthetic agent, and / or- wherein the artificial vitreous is a hydrogel, such as a hyaluronic acid hydrogel, and / or- wherein intravitreal tamponade is selected of one or more from the following: a gas, such as SFe, or a fluorinated alkane; silicone oil.

17. The method according to claim 16, wherein the therapeutically active ingredient is selected from one or more of the following: triamcinolone acetonide; aflibercept; bevacizumab; brolucizumab; ranibizumab; dexamethasone; faricimab; ganciclovir; clindamycin; foscarnet; fomivirsen; methotrexate; vancomycin; ceftazidime; amikacin; amphotericin; voriconazole; pegcetacoplan, ocriplasmin.

18. The method according to any of claims 15 to 17, wherein the therapeutically active ingredient is present as a sustained-release formulation, or wherein the therapeutically active ingredient is contained in a drug-eluting implant.

19. A kit comprising:- an agent for intravitreous administration, and- instructions for determining the amount of agent to be administered based on the vitreous volume of a patient’s eye, wherein the vitreous volume is determined by equation (II)equation (II) wherein: AL is the measured axial length of the eye in millimeters; X has a value of between 0.200 and 0.300; Y has a value of between 0.0050 and 0.0080; V is the vitreous volume V of the eye in mm3.64381 / MB20. The kit according to claim 19, wherein the agent is a medication containing at least one therapeutically active ingredient and / or wherein the agent is artificial vitreous and / or wherein the agent is an intravitreal tamponade.21 . The kit according to claim 20,- wherein the therapeutically active ingredient is selected of one or more from the following: an antibody-based agent, such as an anti-vascular endothelial growth factor; a glucocorticoid; an anti-bacterial agent; and anti-fungal agent; a virostatic agent; a cytostatic agent; an anti-inflammatory agent; a nanoparticle-based medicinal agent; a stem cell-containing agent; a protease; a complement inhibitor; a narcotic agent; an anesthetic agent, and / or- wherein the artificial vitreous is selected of one or more from the following: a gas, such as SF6, or a fluorinated alkane; silicone oil, and / or- wherein the intravitreal tamponade is a hydrogel, such as a hyaluronic acid hydrogel.

22. The kit according to claim 20, wherein the therapeutically active ingredient is selected from one or more of the following: triamcinolone acetonide; aflibercept; bevacizumab; brolucizumab; ranibizumab; dexamethasone; faricimab; ganciclovir; clindamycin; foscarnet; fomivirsen; methotrexate; vancomycin; ceftazidime; amikacin; amphotericin; voriconazole; pegcetacoplan, ocriplasmin.

23. The kit according to any of claims 20 to 22, wherein the therapeutically active ingredient is present as a sustained-release formulation, or wherein the therapeutically active ingredient is contained in a drug-eluting implant.

24. The kit according to any of claims 19 to 23, wherein the agent is contained in a pre-filled syringe.

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