Abstract

Retinal vascular diseases (RVDs) are often treated with intravitreally (IVT) injected drugs, with relatively low patient compliance and potential risks. Ongoing research explores alternative RVD treatments, including eye drops and oral tablets. This study surveyed RVD patients treated with IVT injections to establish factors influencing low compliance rates while gauging treatment delivery method preferences. Demographics, perspectives, and treatment preferences were collected via IRB-approved, self-administered survey sent to Glick Eye Institute patients treated via IVT injections. Demographics, diagnoses, and treatments were ascertained from respondents’ medical records. Gender, age, and number of IVT injections received were used as stratifications. Five-level Likert-style scales and t-tests evaluated responses and stratification comparisons. The most common diagnoses in the respondent population (n = 54; response rate = 5%) were age-related macular degeneration, macular edema, and diabetic retinopathy. Respondents had varying levels of education, income, and age. Most (83%) admitted feeling anxious prior to their first IVT injection, but 80% reported willingness to receive IVT injections indefinitely, with a preference for ophthalmologist visits every 1–3 months. Eye drops would be preferred over IVT injections by 76% of respondents, while 65% preferred oral tablets, due to several perceived negative factors of IVT injections and positive factors for eye drops. Stratified groups did not differ in responses to survey questions. RVD patients will accept IVT injections for vision preservation, but alternative delivery methods like eye drops or oral tablets would be preferred. Thus, development of eye drop and oral therapeutics for RVD treatment is further emphasized by these findings.

Highlights

  • Retinal vascular diseases (RVDs) are often treated with intravitreally (IVT) injected drugs, with relatively low patient compliance and potential risks

  • While eye drop preparations with regorafenib and pazopanib, which inhibit the VEGF receptors (VEGFR) and other kinases, have not proven clinically effective in ­humans[12], oral VEGFR-1 and VEGFR-2 inhibitors have shown promise as therapeutics for neovascular age-related macular degeneration (AMD) based on mouse model d­ ata[13,14,15]

  • Tyrosine kinase inhibitors may result in systemic adverse e­ ffects[13], VEGFR-1 and VEGFR-2 inhibitors are more precise in their ocular tissue u­ ptake[14,15]

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Summary

Introduction

Retinal vascular diseases (RVDs) are often treated with intravitreally (IVT) injected drugs, with relatively low patient compliance and potential risks. This study surveyed RVD patients treated with IVT injections to establish factors influencing low compliance rates while gauging treatment delivery method preferences. RVD patients will accept IVT injections for vision preservation, but alternative delivery methods like eye drops or oral tablets would be preferred. The current cornerstone of pharmacological treatments for retinal vascular diseases (RVDs) such as neovascular age-related macular degeneration (AMD) and diabetic macular edema is intravitreal (IVT) injections of antivascular endothelial growth factor (anti-VEGF) d­ rugs[1,2]. Recent developments in small molecule anti-angiogenic drugs provide potential treatments for these RVDs that could utilize less invasive drug delivery systems, such as eye drops, oral tablets, and subconjunctival or suprachoroidal i­njections[7,8,9,10]. It has been successfully used as an eyedrop to treat choroidal neovascularization in rabbits and non-human p­ rimates[17]

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