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Amphotericin clearance in vitrectomized versus nonvitrectomized eyes.

B H Doft, J Weiskopf, I Nilsson-Ehle

    Ophthalmology
    |November 1, 1985
    PubMed
    Summary

    Amphotericin B clears rapidly from vitrectomized rabbit eyes after intravitreal injection. This rapid ocular clearance necessitates careful consideration for managing fungal endophthalmitis.

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    Area of Science:

    • Ophthalmology
    • Pharmacokinetics
    • Infectious Diseases

    Background:

    • Fungal endophthalmitis is a severe intraocular infection.
    • Intravitreal amphotericin B is a treatment option.
    • Understanding drug clearance is crucial for effective treatment.

    Purpose of the Study:

    • To investigate the ocular pharmacokinetics of amphotericin B.
    • To compare drug clearance in different ocular conditions.
    • To inform clinical management strategies for fungal endophthalmitis.

    Main Methods:

    • A rabbit model was used to study ocular clearance.
    • Intravitreal injections of amphotericin B were administered.
    • High-performance liquid chromatography (HPLC) quantified drug levels.
    • Ocular conditions included unmodified phakic, Candida-infected, aphakic, and aphakic vitrectomized eyes.

    Main Results:

    • Half-lives of amphotericin B disappearance varied significantly across ocular conditions.
    • Half-lives were 9.1 days (unmodified phakic), 8.6 days (Candida-infected), 4.7 days (aphakic), and 1.4 days (aphakic vitrectomized).
    • Vitrectomized eyes showed significantly faster drug clearance (P < 0.001).

    Conclusions:

    • Vitrectomy dramatically accelerates the ocular clearance of intravitreal amphotericin B.
    • This rapid clearance has significant implications for dosing and treatment frequency in patients with fungal endophthalmitis post-vitrectomy.
    • Further studies are needed to optimize treatment regimens based on these pharmacokinetic findings.

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