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Intravitreal Injection of Anti-Vascular Endothelial Growth Factor Agents for Ocular Vascular Diseases: Clinical Practice Guideline Publisher



Nikkhah H1 ; Karimi S1 ; Ahmadieh H1 ; Azarmina M1, 2 ; Abrishami M3 ; Ahoor H4 ; Alizadeh Y5 ; Behboudi H5 ; Daftarian N1 ; Dehghan M2, 6 ; Entezari M6, 7 ; Farrahi F8 ; Ghanbari H9 ; Falavarjani K10 Show All Authors
Authors
  1. Nikkhah H1
  2. Karimi S1
  3. Ahmadieh H1
  4. Azarmina M1, 2
  5. Abrishami M3
  6. Ahoor H4
  7. Alizadeh Y5
  8. Behboudi H5
  9. Daftarian N1
  10. Dehghan M2, 6
  11. Entezari M6, 7
  12. Farrahi F8
  13. Ghanbari H9
  14. Falavarjani K10
  15. Javadi MA1
  16. Karkhaneh R11
  17. Moradian S1, 2, 6
  18. Manaviat MR12
  19. Mehryar M13
  20. Nourinia R1, 2
  21. Parvaresh MM10
  22. Ramezani A1, 6, 7, 14
  23. Haghi AR15
  24. Riaziesfahani M11
  25. Soheilian M1, 2
  26. Shahsavari M2
  27. Shahriari HA16
  28. Rajavi Z1, 6, 7
  29. Safi S2
  30. Shirvani A17
  31. Rahmani S1, 18
  32. Sabbaghi H1, 18
  33. Pakbin M1
  34. Kheiri B1
  35. Ziaei H1, 6
Show Affiliations
Authors Affiliations
  1. 1. Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No 23, Paidarfard St., Boostan 9 St., Pasdaran Ave., Tehran, 16666, Iran
  2. 2. Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Department of Ophthalmology, Mashhad University of Medical Sciences, Mashhad, Iran
  4. 4. Department of Ophthalmology, Tabriz University of Medical Sciences, Tabriz, Iran
  5. 5. Department of Ophthalmology, Guilan University of Medical Sciences, Rasht, Iran
  6. 6. Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  7. 7. Department of Ophthalmology, Torfeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  8. 8. Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  9. 9. Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
  10. 10. Department of Ophthalmology, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
  11. 11. Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
  12. 12. Department of Ophthalmology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  13. 13. Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
  14. 14. Department of Ophthalmology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  15. 15. Department of Ophthalmology, Razavi Hospital, Mashhad, Iran
  16. 16. Department of Ophthalmology, Al-Zahra Eye Center, Zahedan University of Medical Sciences, Zahedan, Iran
  17. 17. Standardization and CPG Development Office, Deputy of Curative Affairs, Ministry of Health and Medical Education, Tehran, Iran
  18. 18. Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Journal of Ophthalmic and Vision Research Published:2018


Abstract

Purpose: To provide the clinical recommendations for the administration of intravitreal anti-vascular endothelial growth factor (VEGF) drugs especially bavacizumab for ocular vascular diseases including diabetic 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 websites and databases were searched to find out the pertinent clinical practice guidelines to answer the questions. The technical committee provided possible answers (scenarios) according to the available evidences for each question. All scenarios along with their levels of evidence and the supported articles were sent to the experts for external review. If the experts did not agree on any of the scenarios for one particular clinical question, the technical committee reviewed all scenarios and their pertinent evidences and made the necessary decision. After that, the experts were asked to score them again. All confirmed scenarios were gathered as the final recommendations. Results: All the experts agreed on at least one of the scenarios. The technical committee extracted the agreed scenario for each clinical question as the final recommendation. Finally, 56 recommendations were developed for the procedure of intravitreal anti-VEGF injection and their applications in the management of ocular vascular diseases. Conclusion: The implementation of this guideline can standardize the management of the common ocular vascular diseases by intravitreal injection of anti-VEGF agents. It can lead to better policy-making and evidence-based clinical decision by ophthalmologists and optimal evidence based eye care for patients. © 2018 Journal of Ophthalmic and Vision Research.
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