Anxiety Levels Before Intravitreal Injections

Anxiety Levels Before Intravitreal Injections IntroductionAge-related macular degeneration (AMD), retinal vein occlusion (RVO), and diabetic retinopathy are prevalent eye conditions that significantly impact individuals and society.Over the past decade, the use of vascular endothelial growth factor (VEGF) antagonists (anti-VEGF therapy) has increased, leading to a rise in the number of intravitreal injections administered for various retinal diseases (1).Numerous large-scale trials have established the safety and effectiveness of anti-VEGF medications in treating neovascular AMD (n-AMD), diabetic macular edema (DME), and macular edema caused by RVO (me-RVO) (2,3).In addition, intravitreal dexamethasone implant injections have been shown to be an effective treatment option for macular edema resulting from other conditions, including RVO (4).Objectives: In our study, using amsterdam pre-operative anxiety and information scale (APAIS) and visual analog scale anxiety (VASA) analyze the patient's anxiety level about intraocular injection therapy and assess possible risk factors for these levels of anxiety in relation to the patient's sociodemographic, disease, and treatment characteristics.Methods: Three hundred sixty-nine patients who received intravitreal ranibizumab, aflibercept, bevacizumab, and dexamethasone implants were included in the study.To measure the level of anxiety, APAIS questionnaire and VASA were used.APAIS and VASA were evaluated according to age, sex, indication for the injection, injection drug, previous injection numbers, and lens status in the study eye.Results: About 15.4% of the patients participating in the study had VASA 6.The APAIS anxiety component score of 43.9% of the patients was found to be 11.Total information requests were found to be 5 in 48.7% of the patients.There was a significant negative correlation between VASA, APAIS, and patient age (spearman r=-0.25,p=0.004, r=-0.22,p=0.001).A significant negative correlation was found between the number of previous injections and anxiety levels measured by VASA (spearman r=-0.35,p=0.02), as well as between the number of previous injections and APAIS scores (anxiety levels and total information request) (spearman r=-0.32,p=0.03).There was a no significant difference between VASA, APAIS, and patient sex (p<0.05).A higher level of anxiety measured by VASA and APAIS has been shown in patients who have not had cataract surgery before, compared to those who have undergone cataract surgery (p<0.05). Conclusion:The study underscores the importance of improving patient information and conducting further research to alleviate stress levels.