The relationship of trust with the doctor is the most important element.
Le intravitreal therapies with anti-VEGF have constituted one of the most important therapeutic revolutions in the treatment of maculopathies and have restored hope to many patients, who until a decade ago had to live with the spectre of impending blindness.
One important aspect that must, however, be given attention is the psychological situation which can occur in patients undergoing therapies that involve the repetition of invasive treatments, such as intravitreal injections.
Anxiety and depression can, in fact, lurk and affect the psychological well-being of these patients. This delicate problem was the subject of a study conducted at the Manchester Royal Eye Hospital and published by theAmerican Journal of Ophthalmology.
Researchers in Manchester identified high levels of undiagnosed anxiety and depression, which persist in patients treated with anti-VEGF, despite improvements in visual function.
The main sources of anxiety were the fear of going blind precisely because of the intravitreal injections and concerns about the effectiveness of the treatment, rather than the pain caused by the intravitreal injection.
Dr. Tariq Aslam, who led the study, stated: "This study is one of the largest and most detailed analyses of patients undergoing anti-VEGF therapy to date, and helps us understand how factors such as patient understanding and building strong relationships with doctors can alleviate anxiety when undergoing intravitreal injections."
The report suggests, in fact, that patients may benefit from additional reassurance from clinical staff about the success rates of anti-VEGF therapy in halting disease progression, how it may reduce the risk of going blind in the future, and the low likelihood of serious side effects following intra-vitreal injections.
Levels of anxiety and depression were generally higher at the start of treatment, while they decreased once anti-VEGF therapy was firmly established. Physicians, however, should remain vigilant and monitor their patients as latent anxiety and depression can significantly affect overall quality of life.
References
Hugo Senra et al, Experience of Anti-VEGF Treatment and Clinical Levels of Depression and Anxiety in Patients With Wet Age-Related Macular Degeneration, American Journal of Ophthalmology (2017). DOI: 10.1016/j.ajo.2017.03.005
Dr. Carmelo Chines
Direttore responsabile
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