Related Experiment Video
Updated: Jan 31, 2026

Intravitreal Injections in the Ovine Eye
Published on: July 5, 2022
Integrated Treatment during the Intravitreal Melphalan Era: Concurrent Intravitreal Melphalan and Systemic
Jesse L Berry1,2, Sona Shah1,2, Fiona Kim1,2
1USC Roski Eye Institute, Los Angeles, California, USA.
Background:
Intravitreal injection of melphalan (IVM) is safe and effective for the treatment of seeding in retinoblastoma. Current protocols require weekly injections during examination under anesthesia (EUA). To avoid additional anesthesia exposure for these children, IVM was initiated at the EUA concurrent with the 4th cycle of systemic chemoreduction in a series of 6 patients with persistent seeding.
Methods:
A retrospective review was completed to assess treatment response compared to all patients at our center treated with IVM and systemic chemotherapy. Overall, 6 eyes of 6 patients were included; salvage therapy included systemic chemoreduction with vincristine, etoposide, and carboplatin and IVM for persistent seeding.
Results:
IVM was initiated in all eyes at cycle 4 of their chemotherapy. Success in eradicating vitreous seeds was 100%; overall salvage rate was 67%. Anterior toxicity was observed in 2 out of 6 eyes and posterior toxicity in 4 out of 6 eyes.
Conclusion:
The concurrent chemoreduction and IVM protocol demonstrated a similar efficacy of globe salvage while sparing children additional EUAs. However, the increased rates of observed melphalan-related toxicities for concurrent therapy are concerning. Further clinical experience is necessary to define the best initiation time and dosing schedule for IVM.
Related Concept Videos
Integration by Parts: Indefinite Integrals
Integration by Parts: Definite Integrals
Second Order systems II
First Order Systems
When a first-order system is subjected to a unit-step input, its response is characterized by its transfer function. By applying the Laplace transform of the unit-step input to the transfer function, expanding the...
Second Order systems I
By reinterpreting the system, one can derive the closed-loop transfer function, which...
Thermodynamic Systems
Consider an example of tea boiling in a kettle. The...

