Patients' knowledge and perspectives on wet age-related macular degeneration and its treatment.
CONCLUSIONS
There have been no studies examining the level of understanding age-related macular degeneration (ARMD) patients have about their disease, or their perceptions about intraocular injections as treatment. In this study, patient knowledge about ARMD risk factors was low but patients appeared more optimistic than fearful when confronted with intraocular antivascular endothelial growth factor (anti-VEGF) injections as treatment.


OBJECTIVE
In recent years there has been an increase in our understanding of wet ARMD, and a dramatic shift in the treatment paradigm. However, to our knowledge, no studies have examined how much ARMD patients understand their disease, or how they feel about receiving intraocular injections as treatment. The primary objectives of this study are to identify areas in which ARMD patients may be uninformed about their disease, and to recognize specific fears or expectations that patients may have regarding treatment with intraocular anti-VEGF injections.


METHODS
Prospective, survey-based study.


METHODS
This is a prospective survey-based study. An anonymous 32-item questionnaire was compiled and distributed to patients with wet ARMD who underwent at least one intraocular anti-VEGF injection. Eighty-three patients from a retina practice in a suburban setting completed the questionnaire that gauged both their knowledge of ARMD and their perspectives on its treatment. Data was analyzed using chi-square testing.


RESULTS
Seventy-eight percent of patients received most of their knowledge of ARMD from their physician. Eighty-nine percent of patients prefer to receive more information on ARMD, if needed, directly from their physician. Only 21%, 48%, 37%, 48%, and 36%, respectively, correctly identified how diet, special vitamins, high blood pressure, family history, and smoking can affect ARMD. Sixty percent felt somewhat afraid or very afraid about getting their first intraocular injection but this did not correlate with pain or discomfort during treatment (P = 0.075, P = 0.117). Eighty-nine percent were very satisfied and 11% were somewhat satisfied with the explanation their physician gave them about the injections. Eighty percent reported feeling hopeful (significantly more than any other emotion) when they were first told they needed an intraocular injection for treatment of their disease.


CONCLUSIONS
Knowledge of risk factors and risk factor modification among patients with ARMD is low. Since the vast majority of ARMD patients prefer to receive information directly from their physician, patient education is crucial in improving risk factor modification and alleviating fears of treatment. With the advent of anti-VEGF agents, patients appear more hopeful of regaining vision than they are fearful of treatment with intraocular injections.
Kandula
Sushma
S
Department of Ophthalmology, Akron OH, USA. kandula7@yahoo.com
Lamkin
Jeffrey C
JC
Albanese
Teresa
T
Edward
Deepak P
DP
N Engl J Med. 2006 Oct 5;355(14):1419-31
17021318
Invest Ophthalmol Vis Sci. 2003 Sep;44(9):3771-7
12939290
Arch Ophthalmol. 2001 Jul;119(7):1050-8
11448327
Arch Ophthalmol. 2004 Apr;122(4):564-72
15078675
Am J Epidemiol. 2001 Aug 1;154(3):207-11
11479184
Arch Ophthalmol. 2007 May;125(5):671-9
17502507
Arch Ophthalmol. 2003 Feb;121(2):211-7
12583787
Ophthalmology. 1992 Jun;99(6):933-43
1630784
Can J Ophthalmol. 2003 Feb;38(1):27-32
12608514
Am J Ophthalmol. 2006 Jul;142(1):1-9
16815245
Arch Ophthalmol. 2006 Jul;124(7):995-1001
16832023
Patient Educ Couns. 1998 May;34(1):63-73
9697558
Arch Ophthalmol. 1998 Dec;116(12):1646-51
9869796
Am J Ophthalmol. 1997 Feb;123(2):199-206
9186125
Ophthalmology. 2002 Jun;109(6):1092-7
12045049
Ophthalmology. 2003 Jun;110(6):1273-80
12799274
Ophthalmology. 2006 Mar;113(3):363-372.e5
16458968
Br J Ophthalmol. 2010 Jan;94(1):2-13
19443462
Arch Ophthalmol. 2007 Jan;125(1):55-62
17210852
Arch Ophthalmol. 2007 Aug;125(8):1089-95
17698756
Klin Monbl Augenheilkd. 2005 Jun;222(6):480-4
15973626
Arch Ophthalmol. 2007 Sep;125(9):1225-32
17846363
Ophthalmology. 2005 Apr;112(4):533-9
15808240
Arch Ophthalmol. 2001 Oct;119(10):1417-36
11594942
Clin Exp Ophthalmol. 2006 Jan-Feb;34(1):9-14
16451252
Ophthalmology. 2008 Jun;115(6):1032-1038.e4
18096234
Aust Fam Physician. 2009 Mar;38(3):172-6
19283260
N Engl J Med. 2006 Oct 5;355(14):1432-44
17021319
Curr Med Res Opin. 2009 Jun;25(6):1413-20
19422281
Am J Ophthalmol. 2004 Apr;137(4):750-2
15059717
J Travel Med. 2005 Apr;12 Suppl 1:S41-6
16225805
Ophthalmology. 2008 Jul;115(7):1203-8
17997484
Ophthalmology. 2004 Jul;111(7):1280-7
15234127
Arch Ophthalmol. 2009 Apr;127(4):533-40
19365036
Arch Ophthalmol. 1992 Dec;110(12):1701-8
1281403
Arch Ophthalmol. 2000 Mar;118(3):351-8
10721957
Eye (Lond). 2005 Sep;19(9):935-44
16151432
Retina. 2006 Apr;26(4):383-90
16603955
Arch Ophthalmol. 2007 Jan;125(1):49-54
17210851