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

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

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

Participants: 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.

Methods: 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.

Main Outcome Measures: 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.

Results: 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.

Conclusions: 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.