A Survey of Patient Perceptions and Preferences for Glaucoma Treatment with Intravitreal Injections

To investigate patient perceptions and preferences regarding the use of intravitreal injection (IVI) for the treatment of glaucoma.

Cross-sectional study of patients seen at the University of Colorado Health Eye Center.

Patients with a diagnosis of glaucoma who were receiving or previously had received topical medication drops and previously had received an IVI for a different eye condition.

In this pilot study, participants were surveyed by telephone using a 10-item questionnaire. Preferences regarding glaucoma treatment methods, specifically a theoretical choice between topical and IVI treatment options, were recorded.

Preferences regarding IVI compared with topical drops in 2 different hypothetical scenarios, one in which both are equally effective and another in which IVI is more effective. Secondary outcomes included preferred interval between injections.

Fifty patients completed the survey. The mean age was 65 years (range, 16-95 years). Patients were using an average of 1.6 glaucoma medications per day (range, 1-4). Seventy-four percent of patients (n = 37) said they would prefer topical medication if equal in efficacy to monthly IVI. In a hypothetical scenario in which a monthly IVI was more effective than topical medication, 76% (n = 38) said they would then prefer injection. Additionally, injection became more preferable as the hypothetical dosing interval changed. Assuming equivalent efficacy, 46% of patients preferred injection if required every 2 months, 62% if required every 3 months, and 82% if injection was required every 6 months. The main reasons cited for preferring topical medications were fear of pain, fear of the procedure, and the inconvenience of more frequent clinic appointments to undergo treatment.

Patients are open to alternative methods of drug delivery, and their willingness to undergo more invasive treatments, like IVI, for glaucoma rises with a longer theoretical duration between treatments.