To provide the clinical recommendations for the usage of intravitreal anti-vascular endothelial growth factor (VEGF) drugs specially bavacizumab in management of common retinal vascular diseases.

Twenty clinical questions were generated and formulated by the guideline technical committee. A number of websites and databases such as Cochrane, National Institute for Clinical Excellence, National Guidelines Clearinghouse and PubMed were searched to find out the relevant clinical practice guidelines to answer the clinical questions. Literature search was also conducted through the PubMed to extract the related articles. The technical committee developed all possible answers (scenarios) based on the available evidences for each question. All scenarios along with their supported articles were sent to the experts for external review. The guideline technical committee asked experts to score each scenario from 1 to 9. The agreement level was determined by analyzing the given scores by experts and the agreed scenario was considered as the final answer to the clinical question. If the experts were not agreed on none of the scenarios of one clinical question, the technical committee reviewed all scenarios and their evidences and made the necessary corrections. Thereafter we asked experts to score them again. The confirmed scenarios were gathered as the final recommendations.

The experts were agreed on at least one of the scenarios. Technical committee extracted the final recommendation using the agreed scenario for each clinical question. Finally, 87 recommendations were developed for the procedure of intravitreal anti-VEGF injection and their application in management of retinal vascular diseases.

The implementation of this guideline can standardize the management of the common retinal vascular diseases by intravitreal injection of anti-VEGF drugs. It leads to better policy-making, evidence-based clinical decision for ophthalmologists and optimal evidence based eye care for patients.