Quality of Life and Treatment Satisfaction in Patients Receiving Intravitreal Injection Therapy for Neovascular Age-Related Macular Degeneration, Diabetic Macular Edema, and Retinal Vein Occlusion: A Cross-Sectional Study

Purpose Neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), and retinal vein occlusion (RVO) are leading causes of vision loss treated with intravitreal injections. The impact of these chronic treatments on patients' vision-related quality of life (QoL) and treatment satisfaction (TS) across different diseases remains unclear. This study aims to evaluate and compare vision-related QoL and TS in patients with nAMD, DME, or RVO undergoing intravitreal therapy, and to identify factors associated with QoL. Methods Single-center cross-sectional study including 88 patients (58 with nAMD, 22 DME, 8 RVO) receiving intravitreal anti-vascular endothelial growth factor (VEGF) or corticosteroid injections (≥3 prior injections). Vision-related QoL was assessed with the National Eye Institute Visual Function Questionnaire-25 (VFQ-25), and TS was measured with the Macular Disease Treatment Satisfaction Questionnaire (MacTSQ). Best-corrected visual acuity (BCVA) of both eyes was measured (logMAR), and a complete ophthalmological examination was performed. We compared VFQ-25 and MacTSQ scores among diagnostic groups and analyzed correlations between QoL, TS, and systemic factors. Multivariable linear regression identified independent predictors of QoL. Results Mean VFQ-25 composite score was 65.1 ± 20.7 (out of 100), indicating moderate QoL impairment, with no significant difference between nAMD, DME, and RVO groups (p = 0.40). Mean MacTSQ score was 81.9 ± 13.5, reflecting high treatment satisfaction, also with no difference among diagnoses (p = 0.14). Worse BCVA (higher mean logMAR of both eyes) and older age were each significantly associated with lower QoL (Spearman r ≈ -0.50 and r ≈ -0.48; p < 0.001). In multivariable analysis, older age (p = 0.004), presence of dyslipidemia (p = 0.03) or depression (p = 0.04), and worse BCVA (p < 0.001) were independent predictors of lower VFQ-25 scores. Diagnostic group, bilateral treatment, and other comorbidities were not independent predictors of QoL. Treatment satisfaction was uniformly high across all groups and was not significantly correlated with age or QoL. Conclusions Patients with nAMD, DME, and RVO receiving intravitreal injections report similar levels of vision-specific QoL impairment and high satisfaction with treatment. Preservation of visual acuity is the key determinant of better QoL, underscoring the importance of effective therapy and adherence. Additionally, older age and systemic factors such as dyslipidemia and depression adversely affect QoL, highlighting the need for a multidisciplinary management approach. These findings suggest that regardless of retinal disease etiology, maintaining vision and addressing comorbidities are critical to optimizing patient-centered outcomes.