Patients’ Experiences of Receiving Anti-VEGF Treatments for Wet Age-Related Macular Degeneration and its Psychological Impact – a mixed-methods study.

Background: Our study aimed to explore patients’ experience of receiving regular intravitreal injections of vascular endothelial growth factor inhibitors (anti-VEGF) for wet Age-related Macular Degeneration (wAMD). We also aimed to investigate the psychological impact of this treatment in terms of levels of anxiety, depression, post-traumatic stress, and burden experienced by patients’ carers. Method: We carried out a mixed-methods study using a structured survey to explore patients’ experience and perceptions of treatment and standardized instruments to assess depression, anxiety, post-traumatic stress and carers’ levels of burden. Results: 150 wAMD patients and 50 carers were interviewed. 12% of patients presented clinical symptoms of anxiety and 10% of patients showed symptoms of depression. Most of patients’ carers (70%) didn’t report burden. The great majority of patients (75%) reported an anxious experience of receiving intravitreal injections. No statistical differences were found in the number of patients reporting anxiety related to the treatment, between patients receiving treatment for up to 1 year and patients receiving treatment for more than 1 year (p = .899). The patients’ main sources of anxiety were the injection itself and the idea of a needle in the eye; fear of further complications caused by injections such as going blind; concerns about the treatment effectiveness; fear of gettinG worse and going blind; and experiences of being very anxious in a medical appointment. Additionally, 45% of patients experienced pain when receiving injections in the eye. Conclusion: Although anti-VEGF treatments have great potential for halting disease progression and preventing further blindness, patients still perceiving this treatment with anxiety. Additionally, the frequency of depression and anxiety symptoms is similar to AMD patients with worse prognosis (e.g. dry AMD). Our study suggests the need to screen wAMD patients for anxiety and depression throughout the treatment, in order to identify patients needing specialized counselling and/or additional psychological / psychiatric follow-up

http://dx.doi.org/10.1016/j.jpsychores.2016.03.199