Factors Associated with Pain Level in Patients Receiving Intravitreal Injection

Abstract

Purpose: To identify the factors associated with the pain level in patients receiving intravitreal injection. Methods: A total of 120 patients were prospectively evaluated, and 104 were included in the study. Patients were asked to rate their pain intensity from 0 to 10 on the visual analog scale. Factors that were possibly associated with pain level were evaluated using a sociodemographic data form, state anxiety inventory, and the hospital anxiety and depression scale. Results: Of the participants, 54 (51.9%) were female, and 50 (48.1%) were male, with a mean age of 65 ± 9.01 years. There was a positive correlation between pain level and state anxiety scores ( r = 0.30; P < 0.001) and a negative correlation between hospital anxiety score ( r = −0.23; P = 0.02) and hospital depression score ( r = −0.27; P = 0.01). The correlation between pain score and education level was significantly higher in primary and secondary school graduates ( P < 0.01). Smokers were observed to have higher pain scores (6.50 ± 2.21 in smokers and 4.87 ± 2.50 in nonsmokers; P = 0.01). Among diagnostic groups, pain scores were found to be significantly lower in the diabetic retinopathy (DR) group (6.82 ± 1.99 in age-related macular degeneration, 5.94 ± 2.27 in retinal vein occlusion, and 3.58 ± 1.97 in DR; P < 0.001). When pain scores were evaluated according to the drug injected, the group receiving bevacizumab injection was observed to have higher pain scores (7.32 ± 1.81 in bevacizumab, 4.00 ± 2.08 in aflibercept, and 3.92 ± 1.96 in ranibizumab; P < 0.001). Based on the multiple regression analysis, the state anxiety score, hospital anxiety score, hospital depression score, and smoking status were observed not to be significant predictors. The level of education, diagnosis, and active substance were found to have a statistically significant effect on pain perception. Conclusion: In this study, pain levels have been found to be high in smokers, those with a low educational level, individuals receiving bevacizumab for intravitreal injection, and those having a higher level of state anxiety, whereas patients with DR have lower pain scores.

Transcorneal Intravitreal Injection Technique for Pediatric Patients With Aphakia and Postvitrectomized Eyes

“…Medication injected into the vitreous chamber may leak into the subconjunctival area, and different components and pH values of drug solutions may cause pain of different intensities. 9 It is well known that pain perception may influence a person's co-operation. Reducing factors that may influence pain perception can contribute to offer these patients greater comfort and influence the behavior during intravitreal injection.…”

Effect of needle size on pain degree and intraocular pressure after intravitreal injection: a randomized observational study

“…Furthermore, the pain experienced by the patient during injection can cause complications due to sudden movements of the eye. The visual analogue Effect of needle size on pain degree and intraocular pressure after intravitreal injection: a randomized observational study www.journals.viamedica.pl/ophthalmology_journal scale (VAS) is a common and easy tool to measure pain sensation, and it is a reliable research method in previous ophthalmology studies [5][6][7][8]. Intraocular pressure (IOP) can increase after this procedure; however, increasing IOP is transient and generally normalizes spontaneously in 30 minutes [9,10].…”