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Comment & Response
February 2015

Is Combination Therapy for Resistant Vitreous Seeds Really Essential?

Author Affiliations
  • 1Sankara Eye Hospital, Bangalore, India
JAMA Ophthalmol. 2015;133(2):231-232. doi:10.1001/jamaophthalmol.2014.4638

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.

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