<?xml version="1.0" encoding="UTF-8"?>
<article article-type="research-article" dtd-version="1.3" xml:lang="en">
  <front>
    <journal-meta>
      <journal-title-group>
        <journal-title>Czech and Slovak Ophthalmology</journal-title>
      </journal-title-group>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">409</article-id>
      <article-id pub-id-type="doi">10.31348/2026/2</article-id>
      <article-categories>
        <subj-group>
          <subject>Recommended Procedures</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Best Practices for Age-Related Macular Degeneration (AMD) Therapy</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Němec</surname>
            <given-names>Pavel</given-names>
          </name>
          <contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4629-1283</contrib-id>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Vysloužilová</surname>
            <given-names>Daniela</given-names>
          </name>
          <contrib-id contrib-id-type="orcid">https://orcid.org/0009-0008-0195-2456</contrib-id>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Hejsek</surname>
            <given-names>Libor</given-names>
          </name>
          <contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9973-8969</contrib-id>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Němčanský</surname>
            <given-names>Jan</given-names>
          </name>
          <contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1979-6419</contrib-id>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Studnička</surname>
            <given-names>Jan</given-names>
          </name>
          <contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9911-4379</contrib-id>
        </contrib>
      </contrib-group>
      <pub-date date-type="pub" publication-format="electronic">
        <day>10</day>
        <month>12</month>
        <year>2025</year>
      </pub-date>
      <issue>3</issue>
      <elocation-id>1</elocation-id>
      <abstract>
        <p>Age-related macular degeneration is one of the leading causes of severe loss of sight in developed countries. Diagnostic procedures have developed dramatically in recent years, and modern imaging methods have contributed to improved options for population screening, targeted diagnostics, and monitoring of the treatment process. At the same time, new treatment options have also been developing rapidly. The recommended procedures summarize the current knowledge with the aim of unifying procedures for the diagnosis, classification, and treatment of age-related macular degeneration (AMD).</p>
      </abstract>
      <kwd-group>
        <kwd>age-related macular degeneration</kwd>
        <kwd>anti-vascular endothelial growth factor</kwd>
        <kwd>choroidal neovascular membrane</kwd>
        <kwd>macular neovascularization</kwd>
        <kwd>diagnostics</kwd>
        <kwd>treatment</kwd>
        <kwd>recommended procedures</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <back>
    <ref-list>
      <title>References</title>
      <ref id="R374">
        <mixed-citation>Klein R, Klein BE, Linton KL. Prevalence of age-related maculopathy. The Beaver Dam Eye Study. Ophthalmology. 1992;99(6):933-943.</mixed-citation>
      </ref>
      <ref id="R375">
        <mixed-citation>Kahn HA, Leibowitz HM, Ganley JP, et al. The Framingham Eye Study. I. Outline and major prevalence findings. Am J Epidemiol. 1977;106(1):17-32.</mixed-citation>
      </ref>
      <ref id="R376">
        <mixed-citation>Sommer A, Tielsch JM, Katz J, et al. Racial differences in the cause- -specific prevalence of blindness in east Baltimore. N Engl J Med. 1991;325(20):1412-1417.</mixed-citation>
      </ref>
      <ref id="R377">
        <mixed-citation>Friedman DS, O’Colmain BJ, Munoz B, et al. Prevalence of age-related macular degeneration in the United States. Arch Ophthalmol. 2004;122(4):564-572.</mixed-citation>
      </ref>
      <ref id="R378">
        <mixed-citation>Congdon N, O’Colmain B, Klaver CC, et al. Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol. 2004;122(4):477-485.</mixed-citation>
      </ref>
      <ref id="R379">
        <mixed-citation>Wong WL, Su X, Li X, et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Glob Health. 2014;2(2):e106-116.</mixed-citation>
      </ref>
      <ref id="R380">
        <mixed-citation>Solomon SD, Lindsley K, Vedula SS, Krzystolik MG, Hawkins BS. Anti-vascular endothelial growth factor for neovascular age- -related macular degeneration. Cochrane Database Syst Rev. 2019;3:CD005139.</mixed-citation>
      </ref>
      <ref id="R381">
        <mixed-citation>Guidelines od American Academy of Ophthalmology (AAO). Available from: https://www.aao.org/preferred-practice-pattern/age- -related-macular-degeneration-ppp-2020</mixed-citation>
      </ref>
      <ref id="R382">
        <mixed-citation>Guidelines od National Institute for Health and Care Excellence (NICE). Available from: https://www.nice.org.uk/guidance/ ng82</mixed-citation>
      </ref>
      <ref id="R383">
        <mixed-citation>Guidelines od Royal College of Ophthalmologists (RCOphth). Available from: https://www.rcophth.ac.uk/wp-content/uploads/ 2019/09/AMD-Guidelines-Sept-2018-FINAL-1.pdf</mixed-citation>
      </ref>
      <ref id="R384">
        <mixed-citation>Tomany SC, Wang JJ, Van Leeuwen R, et al. Risk factors for incident age-related macular degeneration: pooled findings from 3 continents. Ophthalmology. 2004;111(7):1280-1287.</mixed-citation>
      </ref>
      <ref id="R385">
        <mixed-citation>Thornton J, Edwards R, Mitchell P, Harrison RA, Buchan I, Kelly SP. Smoking and age-related macular degeneration: a review of association. Eye. 2005;19:935-944.</mixed-citation>
      </ref>
      <ref id="R386">
        <mixed-citation>Khan JC, Thurlby DA, Shahid H, et al. Smoking and age related macular degeneration: the number of pack years of cigarette smoking is a major determinant of risk for both geographic atrophy and choroidal neovascularisation. Br J Ophthalmol. 2006;90(1):75-80.</mixed-citation>
      </ref>
      <ref id="R387">
        <mixed-citation>Delcourt C, Michel F, Colvez A, Lacroux A, Delage M, Vernet MH. Associations of cardiovascular disease and its risk factors with age- -related macular degeneration: the POLA Study. Ophthalmic Epidemiol. 2001;8(4):237-249.</mixed-citation>
      </ref>
      <ref id="R388">
        <mixed-citation>Fernandez AB, Wong TY, Klein R, et al. Age-related macular degeneration and incident cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis. Ophthalmology. 2012;119(4):765-770.</mixed-citation>
      </ref>
      <ref id="R389">
        <mixed-citation>Hyman L, Schachat AP, He Q, Leske MC. Age-Related Macular Degeneration Risk Factors Study Group. Hypertension, cardiovascular disease, and age-related macular degeneration. Arch Ophthalmol. 2000;118(3):351-358.</mixed-citation>
      </ref>
      <ref id="R390">
        <mixed-citation>van Leeuwen R, Boekhoorn S, Vingerling JR, et al. Dietary intake of antioxidants and risk of age-related macular degeneration. JAMA. 2005;294(24):3101-3107.</mixed-citation>
      </ref>
      <ref id="R391">
        <mixed-citation>Fritsche LG, Igl W, Bailey JN, et al. A large genome-wide association study of age-related macular degeneration highlights contributions of rare and common variants. Nat Genet. 2016;48(2):134-143.</mixed-citation>
      </ref>
      <ref id="R392">
        <mixed-citation>Francis PJ, Klein ML. Update on the role of genetics in the onset of age-related macular degeneration. Clin Ophthalmol. 2011;5:1127- 1133.</mixed-citation>
      </ref>
      <ref id="R393">
        <mixed-citation>Ferris FL, III, Wilkinson CP, Bird A, et al. Clinical classification of age-related macular degeneration. Ophthalmology. 2013;120(4):844-851.</mixed-citation>
      </ref>
      <ref id="R394">
        <mixed-citation>Gass JDM. Stereoscopic Atlas of Macular Diseases: Diagnosis and Treatment. 4th ed. St. Louis, MO: CV Mosby; 1997.</mixed-citation>
      </ref>
      <ref id="R395">
        <mixed-citation>Ryan SJ, Hinton DR, Schachat AP, Wilkinson CP, eds. Retina. 4th ed. St. Louis, MO: CV Mosby; 2005.</mixed-citation>
      </ref>
      <ref id="R396">
        <mixed-citation>Chew EY, Clemons TE, Agron E, et al. Age-Related Eye Disease Study Research Group. Ten-year follow-up of age-related macular degeneration in the age-related eye disease study: AREDS report number 36. JAMA Ophthalmol. 2014;132(3):272-277.</mixed-citation>
      </ref>
      <ref id="R397">
        <mixed-citation>Ferris FL, Davis MD, Clemons TE, et al. Age-Related Eye Disease Study (AREDS) Research Group. A simplified severity scale for age- -related macular degeneration: AREDS report number 18. Arch Ophthalmol. 2005;123(11):1570-1574.</mixed-citation>
      </ref>
      <ref id="R398">
        <mixed-citation>Klein ML, Francis PJ, Ferris FL, III, Hamon SC, Clemons TE. Risk assessment model for development of advanced age-related macular degeneration. Arch Ophthalmol. 2011;129(12):1543-1550.</mixed-citation>
      </ref>
      <ref id="R399">
        <mixed-citation>Klein R, Klein BE, Jensen SC, Meuer SM. The five-year incidence and progression of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology. 1997;104(1):7-21.</mixed-citation>
      </ref>
      <ref id="R400">
        <mixed-citation>Solomon SD, Jefferys JL, Hawkins BS, Bressler NM, Bressler SB. Submacular Surgery Trials Research Group. Risk factors for second eye progression to advanced age-related macular degeneration: SST report number 21. Retina. 2009;29(8):1080-1090.</mixed-citation>
      </ref>
      <ref id="R401">
        <mixed-citation>Sunness JS, Rubin GS, Applegate CA, et al. Visual function abnormalities and prognosis in eyes with age-related geographic atrophy of the macula and good visual acuity. Ophthalmology. 1997;104(10):1677-1691.</mixed-citation>
      </ref>
      <ref id="R402">
        <mixed-citation>Holz FG, Sadda SR, Staurenghi G, et al; CAM Group. Imaging protocols in clinical studies in advanced age-related macular degeneration: recommendations from Classification of Atrophy Consensus Meetings. Ophthalmology 2017; 124(4):464-478.</mixed-citation>
      </ref>
      <ref id="R403">
        <mixed-citation>Holz FG, Strauss EC, Schmitz-Valckenberg S, van Lookeren Campagne M. Geographic atrophy: clinical features and potential therapeutic approaches. Ophthalmology 2014; 121(5):1079-1091.</mixed-citation>
      </ref>
      <ref id="R404">
        <mixed-citation>Sunness JS, Margalit E, Srikumaran D, et al. The long-term natural history of geographic atrophy from age-related macular degeneration: enlargement of atrophy and implications for interventional clinical trials. Ophthalmology 2007; 114(2):271-277.</mixed-citation>
      </ref>
      <ref id="R405">
        <mixed-citation>Pfau M, Lindner M, Goerdt L, Thiele S, et al; Fundus Autofluorescence in Age-Related Macular Degeneration Study Group. Prognostic value of shape-descriptive factors for the progression of geographic atrophy secondary to age-related macular degeneration. Retina. Epub ahead of print 2018 May 16.</mixed-citation>
      </ref>
      <ref id="R406">
        <mixed-citation>Macular Photocoagulation Study Group. Argon laser photocoagulation for neovascular maculopathy: five-year results from randomized clinical trials. Arch Ophthalmol. 1991;109(8):1109-1114.</mixed-citation>
      </ref>
      <ref id="R407">
        <mixed-citation>Yannuzzi LA, Sorenson J, Spaide RF, Lipson B. Idiopathic polypoidal choroidal vasculopathy (IPCV). Retina. 1990;10(1):1-8.</mixed-citation>
      </ref>
      <ref id="R408">
        <mixed-citation>Yannuzzi LA, Negrao S, Iida T, et al. Retinal angiomatous proliferation in age-related macular degeneration. Retina. 2001;21(5):416- 434.</mixed-citation>
      </ref>
      <ref id="R409">
        <mixed-citation>Němec P, Kousal B, Löfflerová V. Optická koherenční tomografie,</mixed-citation>
      </ref>
      <ref id="R410">
        <mixed-citation>Forte R, Coscas F, Serra R, Cabral D, Colantuono D, Souied EH. Long-term follow-up of quiescent choroidal neovascularisation associated with age-related macular degeneration or pachychoroid disease. Br J Ophthalmol. 2020 Aug;104(8):1057-1063.</mixed-citation>
      </ref>
      <ref id="R411">
        <mixed-citation>Vavvas DG, Small KW, Awh CC, Zanke BW, Tibshirani RJ, Kustra R. CFH and ARMS2 genetic risk determines progression to neovascular age-related macular degeneration after antioxidant and zinc supplementation. Proc Natl Acad Sci U S A. 2018;115(4):E696 -E704.</mixed-citation>
      </ref>
      <ref id="R412">
        <mixed-citation>Evans JR, Lawrenson JG. Antioxidant vitamin and mineral supplements for preventing age-related macular degeneration. Cochrane Database Syst Rev. 2012(6):CD000253.</mixed-citation>
      </ref>
      <ref id="R413">
        <mixed-citation>Davis MD, Gangnon RE, Lee LY, et al. Age-Related Eye Disease Study Group. The Age-Related Eye Disease Study severity scale for age-related macular degeneration: AREDS report number 17. Arch Ophthalmol. 2005;123(11):1484-1498.</mixed-citation>
      </ref>
      <ref id="R414">
        <mixed-citation>Age-Related Eye Disease Study 2 Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA. 2013;309(19):2005-2015.</mixed-citation>
      </ref>
      <ref id="R415">
        <mixed-citation>Langrová H, Rencová E, Bláha M, et al. Rheopheresis in the treatment of age-related macular degeneration. Cesk Slov Oftalmol. 2022 Winter;79(1):8-24.</mixed-citation>
      </ref>
      <ref id="R416">
        <mixed-citation>ASFA Guidelines, Special Issue-Clinical Applications of Therapeutic Apheresis-An Evidence Based Approach. 7th Edition_JClinApher. 2016 Jun_31(3):169-170.</mixed-citation>
      </ref>
      <ref id="R417">
        <mixed-citation>Rencová E, Bláha M, Studnička J, et al. Reduction in the drusenoid retinal pigment epithelium detachment area in the dry form of age-related macular degeneration 2.5 years after rheohemapheresis. Acta Ophthalmol 2013;91:406-408.</mixed-citation>
      </ref>
      <ref id="R418">
        <mixed-citation>Holz FG, Sadda SR, Busbee B, et al. Efficacy and Safety of Lampalizumab for Geographic Atrophy Due to Age-Related Macular Dege- neration: Chroma and Spectri Phase 3 Randomized Clinical Trials. JAMA Ophthalmol. 2018;136(6):666-677.</mixed-citation>
      </ref>
      <ref id="R419">
        <mixed-citation>Heier JS, Lad EM, Holz FG, et al. OAKS and DERBY study investigators. Pegcetacoplan for the treatment of geographic atrophy secondary to age-related macular degeneration (OAKS and DERBY): two multicentre, randomised, double-masked, sham-controlled, phase 3 trials. Lancet. 2023 Oct 21;402(10411):1434-1448.</mixed-citation>
      </ref>
      <ref id="R420">
        <mixed-citation>Khanani AM, Patel SS, Staurenghi G, et al. GATHER2 trial investigators. Efficacy and safety of avacincaptad pegol in patients with geographic atrophy (GATHER2): 12-month results from a randomised, double-masked, phase 3 trial. Lancet. 2023 Oct 21;402(10411):1449-1458.</mixed-citation>
      </ref>
      <ref id="R421">
        <mixed-citation>Solomon SD, Lindsley K, Vedula SS, Krzystolik MG, Hawkins BS. Anti-vascular endothelial growth factor for neovascular age-related macular degeneration. Cochrane Database Syst Rev. 2019 Mar 4;3(3):CD005139.</mixed-citation>
      </ref>
      <ref id="R422">
        <mixed-citation>Oncel D, Oncel D, Mishra K, Oncel M, Arevalo JF. Current Management of Subretinal Hemorrhage in Neovascular Age-Related Macular Degeneration. Ophthalmologica. 2023;246(5-6):295-305.</mixed-citation>
      </ref>
      <ref id="R423">
        <mixed-citation>Cruess AF, Zlateva G, Pleil AM, Wirostko B. Photodynamic therapy with verteporfin in age-related macular degeneration: a systematic review of efficacy, safety, treatment modifications and pharmacoeconomic properties. Acta Ophthalmol. 2009 Mar;87(2):118- 132.</mixed-citation>
      </ref>
      <ref id="R424">
        <mixed-citation>Virgili G, Bini A. Laser photocoagulation for neovascular age-related macular degeneration. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004763.</mixed-citation>
      </ref>
      <ref id="R425">
        <mixed-citation>Amoaku WM, Chakravarthy U, Gale R, et al. Defining response to anti-VEGF therapies in neovascular AMD. Eye (Lond). 2015 Jun;29(6):721-731.</mixed-citation>
      </ref>
      <ref id="R426">
        <mixed-citation>Heier JS, Brown DM, Chong V, et al. VIEW 1 and VIEW 2 Study Groups. Intravitreal aflibercept (VEGF trap-eye) in wet age-related macular degeneration. Ophthalmology. 2012 Dec;119(12):2537- 2548.</mixed-citation>
      </ref>
      <ref id="R427">
        <mixed-citation>Lanzetta P, Korobelnik JF, Heier JS, et al. PULSAR Investigators. Intravitreal aflibercept 8 mg in neovascular age-related macular degeneration (PULSAR): 48-week results from a randomised, double-masked, non-inferiority, phase 3 trial. Lancet. 2024 Mar 23;403(10432):1141-1152.</mixed-citation>
      </ref>
      <ref id="R428">
        <mixed-citation>Dugel PU, Koh A, Ogura Y, et al. HAWK and HARRIER Study Investigators. HAWK and HARRIER: Phase 3, Multicenter, Randomized, Double-Masked Trials of Brolucizumab for Neovascular Age-Related Macular Degeneration. Ophthalmology. 2020 Jan;127(1):72- 84.</mixed-citation>
      </ref>
      <ref id="R429">
        <mixed-citation>Khanani AM, Kotecha A, Chang A, et al. TENAYA and LUCERNE Investigators. TENAYA and LUCERNE: Two-Year Results from the Phase 3 Neovascular Age-Related Macular Degeneration Trials of Faricimab with Treat-and-Extend Dosing in Year 2. Ophthalmology. 2024 Feb 19:S0161-6420(24)00134-9.</mixed-citation>
      </ref>
      <ref id="R430">
        <mixed-citation>Rosenfeld PJ, Brown DM, Heier JS, et al. MARINA Study Group. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006 Oct 5;355(14):1419-1431.</mixed-citation>
      </ref>
      <ref id="R431">
        <mixed-citation>Brown DM, Michels M, Kaiser PK, Heier JS, Sy JP, Ianchulev T; AN- CHOR Study Group. Ranibizumab versus verteporfin photodynamic therapy for neovascular age-related macular degeneration: Two-year results of the ANCHOR study. Ophthalmology. 2009 Jan;116(1):57-65.e5.</mixed-citation>
      </ref>
      <ref id="R432">
        <mixed-citation>Rayess N, Rahimy E, Storey P, et al. Postinjection endophthalmitis rates and characteristics following intravitreal bevacizumab, ranibizumab and aflibercept. Am J Ophthalmol. 2016; 165:88-93.</mixed-citation>
      </ref>
      <ref id="R433">
        <mixed-citation>Pilli S, Kotsolisn A, Spaide RF, et al. Endophthalmitis associated with intravitreal anti-vascular endothelial growth factor therapy injections in an office setting. Am J Ophthalmol. 2008; 145:879-882.</mixed-citation>
      </ref>
      <ref id="R434">
        <mixed-citation>Freiberg FJ, Brynskov T, Munk MR, et al. Low endophthalmitis rates after intravitreal antivascular endothelial growth factor injections in an operation room: a retrospective multicenter study. Retina. 2017; 37:2341-2346.</mixed-citation>
      </ref>
      <ref id="R435">
        <mixed-citation>Brynskov T, Kemp H, Sorensen TL. No cases of endophthalmitis after 20,293 intravitreal injections in an operating room setting. Retina 2014; 34:951-957.</mixed-citation>
      </ref>
      <ref id="R436">
        <mixed-citation>Schwartz SG, Flynn HW, Grzybowski A. Controversies in topical antibiotics use with intravitreal injections. Curr Pharm Des. 2015;21:4703-4706.</mixed-citation>
      </ref>
      <ref id="R437">
        <mixed-citation>Schwartz SG, Grzybowski A, Flynn HW Jr. Antibiotic prophylaxis: different practice patterns within and outside the United States. Clin Ophthalmol. 2016;10:251-256.</mixed-citation>
      </ref>
      <ref id="R438">
        <mixed-citation>Benoist d’Azy C, Pereira B, Naughton G, Chiambaretta F, Dutheil F. Antibioprophylaxis in prevention of endophthalmitis in intravitreal injection: a systematic review and meta-analysis. PLoS One. 2016;11:e0156431.</mixed-citation>
      </ref>
      <ref id="R439">
        <mixed-citation>Aiello LP, Brucker AJ, Chang S, et al. Evolving guidelines for intravitreous injections. Retina 2004;24:S3–S19.</mixed-citation>
      </ref>
      <ref id="R440">
        <mixed-citation>Ali T, Jung K, Montan PG. Eyelid skin disinfecting and conjunctival bacteria in cataract surgery. Acta Ophthalmol. 2013;91:114-117.</mixed-citation>
      </ref>
      <ref id="R441">
        <mixed-citation>Wen JC, McCannel CA, Mochon AB, Garner OB. Bacterial dispersal associated with speech in the setting of intravitreous injections. Arch Ophthalmol. 2011;129:1551-1554.</mixed-citation>
      </ref>
      <ref id="R442">
        <mixed-citation>Berkelman RL, Holland BW, Anderson RL. Increased bactericidal activity of dilute preparations of povidone-iodine solutions. J Clin Microbiol. 1982;15:635-639.</mixed-citation>
      </ref>
      <ref id="R443">
        <mixed-citation>Wykoff CC, Flynn HW Jr, Rosenfeld PJ. Prophylaxis for endophthalmitis following intravitreal injection: antisepsis and antibiotics. Am J Ophthalmol. 2011;152:717-719.e712.</mixed-citation>
      </ref>
      <ref id="R444">
        <mixed-citation>Fineman MS, Hsu J, Spirn MJ, Kaiser RS. Bimanual assisted eyelid retraction technique for intravitreal injections. Retina. 2013;33:1968- 1970.</mixed-citation>
      </ref>
      <ref id="R445">
        <mixed-citation>Rahimy E, Fineman MS, Regillo CD, et al. Speculum versus bimanual lid retraction during intravitreal injection. Ophthalmology. 2015;122:1729-1730.</mixed-citation>
      </ref>
      <ref id="R446">
        <mixed-citation>Shrier EM. Cotton-tip applicator lid retraction technique for controlled intravitreal injection. Retina 2014;34:1244-1246.</mixed-citation>
      </ref>
      <ref id="R447">
        <mixed-citation>Eaton AM, Gordon GM, Wafapoor H, Sgarlata A, Avery RL. Assessment of novel guarded needle to increase patient comfort and decrease injection time during intravit real injection. Ophthalmic Surg Lasers Imaging Retina. 2013;44:561-568.</mixed-citation>
      </ref>
      <ref id="R448">
        <mixed-citation>Mayer CH, Fung A, Saxena S, Holz FG. Steps for a safe intravitreal injection technique. Retinal Physician. 2009. http://www.retinalphysician.com/articleviewer.aspx?articleid = 103195</mixed-citation>
      </ref>
      <ref id="R449">
        <mixed-citation>Berkelman RL, Holland BW, Anderson RL. Increased bactericidal activity of dilute preparations of povidone-iodine solutions. J Clin Microbiol. 1982;15:635-639.</mixed-citation>
      </ref>
      <ref id="R450">
        <mixed-citation>Avery RL, Bakri SJ, Blumenkranz MS, et al. Intravitreal injection technique and monitoring: updated guidelines of an expert panel. Retina. 2014;34:S1-S18.</mixed-citation>
      </ref>
      <ref id="R451">
        <mixed-citation>McCannel CA. Meta-analysis of endophthalmitis after intravitreal injection of anti-vascular endothelial groty factor agents: causative organisms and possible prevention strategies. Retina. 2011;31:654-661.</mixed-citation>
      </ref>
      <ref id="R452">
        <mixed-citation>Green-Simms AE, Ekdawi NS, Bakri SJ. Survey of intravitreal injection techniques among retinal specialists in the United States. Am J Ophthalmol. 2011;151:329-332.</mixed-citation>
      </ref>
      <ref id="R453">
        <mixed-citation>Yanagi Y, Tsujimura J, Ohno S, et al. Cost-effectiveness analysis of bispecific antibody faricimab for treatment of neovascular age-related macular degeneration and diabetic macular edema in Japan. J Med Econ. 2025 Dec;28(1):448-459. doi: 10.1080/13696998.2025.2478755<pub-id pub-id-type="doi">10.1080/13696998.2025.2478755</pub-id></mixed-citation>
      </ref>
      <ref id="R454">
        <mixed-citation>Quist SW, Nab H, Postma M. et al. A cost-minimization analysis of anti-VEGFs for the treatment of neovascular age-related macular degeneration in the Netherlands. Graefes Arch Clin Exp Ophthalmol. 2025;263,327-345. https://doi.org/10.1007/s00417-024-06588-6<pub-id pub-id-type="doi">10.1007/s00417-024-06588-6</pub-id></mixed-citation>
      </ref>
      <ref id="R455">
        <mixed-citation>El-Dahiyat F, Eljilany I. Cost-Minimization Analysis of Ranibizumab Versus Aflibercept for Treating Saudi Patients With Visual Impairment Owing to Age-Related Macular Degeneration or Diabetic Macular Edema. Value Health Reg Issues. 2020 Sep;22:23-26. doi: 10.1016/j.vhri.2019.09.007<pub-id pub-id-type="doi">10.1016/j.vhri.2019.09.007</pub-id></mixed-citation>
      </ref>
      <ref id="R456">
        <mixed-citation>Bührer C, Paling T, Gale R, et al. Cost-Effectiveness of Faricimab in the Treatment of Diabetic Macular Oedema (DMO): A UK Analysis. PharmacoEconomics Open. 2024;8:445-457. https://doi. org/10.1007/s41669-023-00465-4<pub-id pub-id-type="doi">10.1007/s41669-023-00465-4</pub-id></mixed-citation>
      </ref>
      <ref id="R457">
        <mixed-citation>Diles D, Wong D, Gizicki R, Icente C, Bührer C. Cost-Effectiveness of Faricimab in Canada for the Treatment of Patients With Macular Edema Secondary to Retinal Vein Occlusion. Value in Health. 2024;27(12): S197.</mixed-citation>
      </ref>
      <ref id="R458">
        <mixed-citation>Casselholm de Salles M, Amrén U, Kvanta A, Epstein DL. Injection frequency of aflibercept versus ranibizumab in a treat-and-extend regimen for central retinal vein occlusion: A Randomized Clinical Trial. Retina. 2019;39(7):1370-1376.</mixed-citation>
      </ref>
      <ref id="R459">
        <mixed-citation>Hykin P, Prevost AT, Vasconcelos JC, et al. Clinical Effectiveness of Intravitreal Therapy With Ranibizumab vs Aflibercept vs Bevacizumab for Macular Edema Secondary to Central Retinal Vein Occlusion: A Randomized Clinical Trial. JAMA Ophthalmol. 2019;137(11):1256-1264.</mixed-citation>
      </ref>
    </ref-list>
  </back>
</article>
