Patient Needs Before Intravitreal Injection

An observational, cross-sectional study assessed feelings, preoperative anxiety, and need for information in patients undergoing intravitreal injections (IVIs).

Consecutive patients receiving IVI treated at a single tertiary university care center between December 2017 and December 2018 were asked to fill out a paper survey before and after IVI to discuss their experience. The Amsterdam Preoperative Anxiety Information Scale (APAIS) score was used to determine preoperative anxiety and need for information. Preoperative anxiety was defined as an APAIS score ≥11, and the need for information was defined as an APAIS score ≥5.

Final analysis included responses from 100 patients (mean age, 76.5 years). Both eyes had a median best-corrected visual acuity (BCVA) of 0.4 logMAR. Most IVI indications were wet age-related macular degeneration (n=58), diabetic macular edema (n=19), or venous occlusion (n=16). The most unpleasant IVI steps were using an eyelid retractor, needle entry, changing of physician from one IVI to another, the pre-IVI waiting time, and the high number of IVIs required for disease control. Upon multivariate analysis, preoperative anxiety was correlated with the need for information, changing of ophthalmologist between different IVI sessions, and pain expected before the IVI. The need for information was correlated with the preoperative anxiety.

“Preoperative anxiety and need for information are common in patients undergoing IVI even after many IVIs. Being injected by different practitioners was strongly correlated with preoperative anxiety and should be avoided as much as possible,” the study authors summarized. They recommended that better educational and information programs be utilized.