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The analysis included 101 patients treated with aflibercept 2\u2009mg and modeled the environmental impact of transitioning to aflibercept 8\u2009mg. The simulated aflibercept 8\u2010mg cohort was generated by replicating the demographic and logistical characteristics of the real\u2010world aflibercept 2\u2010mg population while applying extended dosing intervals. Emissions were estimated in CO\n                      <jats:sub>2<\/jats:sub>\n                      equivalents (CO\n                      <jats:sub>2<\/jats:sub>\n                      e) and included drug manufacturing, clinical materials, patient transportation, energy use, and waste disposal. Emission factors were derived from Defra and ecoinvent databases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients treated with aflibercept 2\u2009mg generated an average carbon footprint of 1150\u2009kg CO\n                      <jats:sub>2<\/jats:sub>\n                      e per treatment cycle (2\u2009years), compared to 746\u2009kg CO\n                      <jats:sub>2<\/jats:sub>\n                      e for those modeled to receive aflibercept 8\u2009mg. This corresponds to an absolute reduction of 404\u2009kg CO\n                      <jats:sub>2<\/jats:sub>\n                      e and a relative reduction of 35%. The main driver of emissions was pharmaceutical procurement, followed by patient transportation. The lower injection frequency enabled by aflibercept 8\u2009mg significantly reduced both sources of emission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A transition from conventional aflibercept 2\u2010mg therapy to an aflibercept 8\u2010mg regimen with extended dosing intervals reduces the treatment\u2019s carbon footprint by over one\u2010third. These findings support the integration of environmental considerations into therapeutic decisions in ophthalmology, particularly for high\u2010frequency procedures, such as intravitreal injections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/joph\/9131955","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:27:06Z","timestamp":1772990826000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Reducing the Carbon Footprint of Neovascular Age\u2013Related Macular Degeneration Therapy: Environmental Impact of Transitioning to Aflibercept 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