intravitreal injection of anti‑vascular endothelialgrowth factor agents for ocular vasculardiseases: clinical practice guideline

Purpose: to provide the clinical recommendations for the administration of intravitreal anti‑vascularendothelial growth factor (vegf) drugs especially bavacizumab for ocular vascular diseases includingdiabetic macular edema, neovascular age‑related macular degeneration, myopic choroidal neovascularization,retinal vein occlusion and central serous chorioretinopathy.methods: twenty clinical questions were developed by the guideline technical committee. relevant websitesand databases were searched to fnd out the pertinent clinical practice guidelines to answer the questions.the technical committee provided possible answers (scenarios) according to the available evidences foreach question. all scenarios along with their levels of evidence and the supported articles were sent to theexperts for external review. if the experts did not agree on any of the scenarios for one particular clinicalquestion, the technical committee reviewed all scenarios and their pertinent evidences and made thenecessary decision. after that, the experts were asked to score them again. all confrmed scenarios weregathered as the fnal recommendations.results: all the experts agreed on at least one of the scenarios. the technical committee extracted theagreed scenario for each clinical question as the fnal recommendation. finally, 56 recommendations weredeveloped for the procedure of intravitreal anti‑vegf injection and their applications in the managementof ocular vascular diseases.conclusion: the implementation of this guideline can standardize the management of the common ocularvascular diseases by intravitreal injection of anti‑vegf agents. it can lead to better policy‑making andevidence‑based clinical decision by ophthalmologists and optimal evidence based eye care for patients.