We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Comment & Response |

Is Combination Therapy for Resistant Vitreous Seeds Really Essential?

Rajesh Ramanjulu, MD, DNB, FVR, FAICO(VR)1; Mahesh Shanmugam Palanivelu, FRCSEd, DO, FRCS(Edin), PhD1
[+] Author Affiliations
1Sankara Eye Hospital, Bangalore, India
JAMA Ophthalmol. 2015;133(2):231-232. doi:10.1001/jamaophthalmol.2014.4638.
Text Size: A A A
Published online


To the Editor We read the article by Ghassemi et al1 about the combination treatment with intravitreal melphalan hydrochloride and topotecan hydrochloride for resistant vitreous seeds with great interest. The 3 main practical concerns regarding the rationale for this therapy include the following: (1) the primary question, ie, does the need for such a regimen really exist? (2) the potential increased toxic effects of both drugs combined on the retina and photoreceptors; and (3) the risk of malignancy and surgery-related complications due to multiple injection sites.

Figures in this Article


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Effect of Intravitreal Melphalan on Retinal Pigment Epithelium

Vast retinal pigment epithelial atrophy (outline) after 3 doses of intravitreal melphalan hydrochloride.

Graphic Jump Location




February 1, 2015
Fariba Ghassemi, MD; Carol L. Shields, MD; Alireza Khodabande, MD
1Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
2Ocular Oncology Service, Wills Eye Hospital, Philadelphia, Pennsylvania
JAMA Ophthalmol. 2015;133(2):232-233. doi:10.1001/jamaophthalmol.2014.4657.
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...