Evaluation of pain scores during intravitreal injection in systemic conditions and in conjunction with medications.

Abstract

Background: Intravitreal injection (IVI) is a common practice in today's ophthalmology clinics. The pain that patients will experience after the application may be important in compliance with the treatment.

Objectives: This study aimed to investigate the correlation between various clinical characteristics of patients receiving IVI and corresponding visual analogue scale (VAS) scores (0: no pain to 10: severe pain).

Design: Single-centre, Prospective study.

Methods: A total of 313 participants (168 females, 145 males) with a mean age of 66.91 ± 9.67 years underwent IVI for diabetic retinopathy (DRP), retinal vein occlusion (RVO), or age-related macular degeneration (AMD). Eye examinations, including visual acuity and intraocular pressure measurements, were also conducted, and injection indications were determined based on dilated fundus examinations and spectral domain optical coherence tomography images. Following the injections, the researchers solicited VAS scores ranging from 0 to 10 (no pain to severe pain). The study explored the relationships between clinical characteristics, headache frequency, joint and muscle pain, analgesic use, surgical history, antidepressant use, vasovagal syncope, previous injections, and VAS score.

Results: The mean VAS score was 4.77 ± 2.90. While DRP and RVO had similar VAS scores (4.95 ± 2.98 and 5.22 ± 2.70, respectively), the AMD group had significantly lower scores (4.09 ± 2.64). Compared with nonusers, antidepressant users had significantly greater VAS scores (5.79 ± 3.43) (4.52 ± 2.70) (p < 0.05). Patients with a history of syncope had significantly greater VAS scores (p < 0.05). In patients reporting monthly headaches, a positive correlation was found between headache frequency and VAS score (r = 0.23, p < 0.01).

Conclusion: For individuals experiencing daily headaches, inquiries about vasovagal syncope and antidepressant use may be beneficial, considering the potential association of these symptoms with higher VAS scores after IVIs.