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Feelings, preoperative anxiety, and need for information in patients undergoing intravitreal injections

  • Retinal Disorders
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To assess feelings, preoperative anxiety, and need for information in patients undergoing intravitreal injections (IVI).


An observational cross-sectional study was conducted in our tertiary university care center between December 2017 and December 2018. Consecutive patients undergoing IVI were included. A paper survey was completed before and after IVI to assess patient experience. Preoperative anxiety and need for information were assessed using the Amsterdam Preoperative Anxiety Information Scale (APAIS) score.


Hundred patients with a median age of 76.5 years (42–95, SD = 10.1) were included. Median best-corrected visual acuity (BCVA) in both eyes was 0.4 logMAR. Main IVI indications were wet age-related macular degeneration (n = 58), diabetic macular edema (n = 19), and venous occlusion (n = 16). The IVI most unpleasant steps were as follows: using an eyelid retractor, needle entry, changing of physician from one IVI to another, the pre-IVI waiting time, and the high number of IVI required for disease control. Preoperative anxiety (APAIS score ≥ 11) was correlated in the multivariate analysis with the need for information (p = 0.004), changing of ophthalmologist between different IVI sessions (p = 0.006), and pain expected before the IVI (p = 0.010). The need for information (APAIS score ≥ 5) was only associated with the preoperative anxiety in the multivariate analysis (p = 0.001).


Preoperative anxiety and need for information are common in patients undergoing IVI even after many IVI. Being injected by different practitioners was strongly correlated with preoperative anxiety and should be avoided as much as possible. Better educational and information programs are needed.

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Correspondence to A. Martel.

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Conflict of interest

Baillif, Stephanie has received research grants from Allergan, Bayer, Novartis, and Horus Pharma. The other authors have no affiliation with any organization or entity with any financial interest.

Ethical approval

The study conduct was approved by the Commission Nationale Informatique et Libertés (CNIL Number: 2004024 v 0) and was performed in accordance with the ethical standards outlined by the 1964 Helsinki Declaration and its latter amendments.

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Informed consent was obtained from all individual participants included in the study.

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Martel, A., Nahon-Esteve, S., Martini, K. et al. Feelings, preoperative anxiety, and need for information in patients undergoing intravitreal injections. Graefes Arch Clin Exp Ophthalmol 258, 1395–1403 (2020).

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