E-mental health treatment for patients with eye diseases (E-PsEYE): pilot study

Retinal exudative diseases are the leading cause of vision loss in older adults. They cause pathologically changed, and newly formed blood vessels to leak and damage the retina, reducing vision. There is no cure for these diseases, but pharmacological inhibition of the vascular endothelial growth factor (VEGF) in the eye can have a beneficial effect. Anti-VEGF drugs are injected into the eye at various intervals. In approximately one third of cases these injections lead to substantial improvement in vision. However, about one third will perceive further vision loss despite treatment, and the effects vary strongly between patients.



The uncertainty of progressive vision loss and the effectiveness of anti-VEGF injections can have a great impact on the psychological well-being of patients. Research shows that approximately one in three patients experience mild symptoms of depression and/or anxiety. These symptoms are the most important predictors of developing a DSM-V depressive or anxiety disorder and can lead to increased vision-specific disability, decreased health-related quality of life, and increased mortality.



To support patients in dealing with these symptoms, a cognitive behavioural therapy (CBT)-based e-mental health intervention was developed. This intervention is expected to be cost-effective, since it is accessible (i.e., patients can use it at home), patient empowerment is stimulated, and relatively little effort from professionals is needed.



The aim of this pilot study is to examine the feasibility of E-PsEYE in a pilot study as a prelude to performing a randomized controlled trial (RCT).

It is feasible to investigate the (cost)effectiveness of E-PsEYE in reducing depression and anxiety symptomatology in a randomized controlled trial (RCT).

All outcomes are measured at baseline and after 3 months by means of written questionnaires (before and after study).

A cognitive behavioural therapy-based e-mental health intervention (offered via the Internet) will be investigated, consisting of nine modules designed to reduce depression and anxiety and increase adaptation to vision loss.