Survey of the current state of intravitreal therapy in Spain

Intravitreal injections are the most frequently performed intraocular procedure in ophthalmology; however, limited data exist regarding their organizational implementation in Spain. This study evaluated the current status of intravitreal therapy in Spanish hospitals and clinics.

A structured national survey comprising 46 questions grouped into nine thematic sections was conducted. The survey was voluntarily distributed using a nonprobability sampling strategy through professional networks across Spain. Duplicate responses were excluded.

A total of 172 responses were received, of which 129 unique responses were analyzed. Most centers (89.84%) lacked formal agreements with primary care. However, 64.34% reported having referral protocols from outpatient clinics, and 66% had written protocols for managing macular diseases. Only 39.53% had a dedicated intravitreal therapy unit, whereas an additional 33% reported nursing or administrative coordination specifically assigned to intravitreal therapy. Only 27.81% had an efficient system for reviewing clinical outcomes of intravitreal injections, and 6% used artificial intelligence systems for optical coherence tomography analysis. Patient safety was a shared concern, and most centers reported safety incidents.

Intravitreal therapy delivery in Spain demonstrates substantial organizational variability. No relevant differences were observed between public and private sectors. Areas for improvement include coordination with primary care, implementation of standardized protocols, and equitable access to resources.