Patient treatment preference in non-infectious intermediate, posterior, panuveitis, episcleritis, or scleritis

Abstract

Purpose : This index before-and-after study aims to evaluate treatment-naive patient preferences regarding management options for non-infectious intermediate, posterior, and panuveitis, along with episcleritis and scleritis before and after receiving written information about the risks and benefits of different treatment options.

Methods : Consecutive new referrals to the Uveitis Service at a tertiary academic center were consented to join the survey. The key inclusion criteria were age 18 to 75, treatment-naive except for oral steroids, and a provisional diagnosis of non-infectious intermediate, posterior, and panuveitis, episcleritis, or scleritis. Thirty-seven eligible patients were enrolled from September 2022 to September 2023. Prior to consultation with the treating physician, patients were asked to complete a survey regarding their preferences towards local versus systemic therapy before being provided with information. Subsequently, written information regarding the risks and benefits of different treatment options was provided to the patients. The patients were then surveyed again about their treatment preferences and the side effects that worry them the most.

Results : The mean age of participants was 47.43±17 years, and 30 (81%) were female (Table). Initially, 23 (62%) patients favored systemic therapies over local injection treatment; 4 (10.8%) changed preferences after the written information was provided, with 2 (5.4%) shifting from systemic to local and 2 (5.4% ) vice versa. The most concerning side effects were complications from local injection (56.5%) and bone marrow suppression (78.5%) in the patients who selected systemic and local treatment, respectively. No significant relationship was observed among patients’ treatment preference and chronicity, laterality of disease, and BCVA (p-value=0.48, 0.49, 0.9).

Conclusions : In this cohort, patients generally preferred systemic treatments over local injections. Chronicity, BCVA, and laterality did not affect the choices. The main concern was their fear of injections into the eye. Provided written information only altered the decision of a small proportion of patients.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Patient treatment preference demographics