Abstract
Introduction: Age- related Macular Degeneration (AMD) is the commonest cause of irreversible blindness and visual impairment in elderly, aged50 years or older contributing 8.7% of global blindness. Among the two types: “dry” and “wet”, the “wet” variant is treated using anti-VEGFs, mainly via two regimen – PRN or TREX.
 Objective: To study and compare the compliance, cost and visual outcome of “Treat-and- Extend (TREX)”versus “Pro Re Nata(PRN)” dosing of intravitrealbevacizumab in Wet AMD.
 Methodology: Sixty-four eyes of 64 patients with treatment naïve neovascular AMD were included and randomly divided into two groups, with each group comprising 32 eyes, by lottery system: “Group A [TREX]” and “Group B [PRN]”. Group A was treated with intravitrealbevacizumab [1.25mg/0.05ml] at presentation and at 1-month interval for 3 consecutive months [loading dose] and monthly till dry macula was obtained. Group B was treated with the same in “as needed” basis.Both Groups were followed up, for 1 year.
 Results Mean gain in visual acuity in the PRN group was 0.09 +/- 0.35 log MAR unit and in TREX, it was 0.14 +/- 0.3 log MAR unit within the period of 1 year.64% of the patients were compliant in TREX and 36% moderately complaint whereas in the PRN group, 24% were compliant, 60% moderately compliant and 16% noncompliant. Average hospital cost in PRN and TREX was NRs. 16, 170 (USD 149) and 23,785(USD 220) respectively.
 Conclusion: Compliance and visual outcome were better in TREX in comparison toPRN at 1 year of treatment with intravitrealbevacizumab for Wet AMD.
Highlights
Age- related Macular Degenera on (AMD) is the commonest cause of irreversible blindness and visual impairment in elderly, 50 years or older contribu ng 8.7% of global blindness.[1,2] Prevalence of AMD was found to be 3.1%10.6% in Asian peoples
A hospital-based prospec ve, observa on alanaly cal study was performed in 64 eyes of 64 pa ents diagnosed with treatment naïve wet AMD with choroidal neovasculariza on, aged 50 years or older and randomly divided into two groups, with each group comprising 32 eyes, by lo ery system: “Group A [Treat-and- Extend (TREX)]” and “Group B [PRN]”
Pa ents aging from 50 years to those more than 80 years were included in the study (Figure 1)
Summary
Age- related Macular Degenera on (AMD) is the commonest cause of irreversible blindness and visual impairment in elderly, 50 years or older contribu ng 8.7% of global blindness.[1,2] Prevalence of AMD was found to be 3.1%10.6% in Asian peoples. In a previous popula on-based study in Nepal, AMD was found to contribute 8.7% of total blindness.[3] It is o en considered as a disorder primarily affec ng macula which is characterized by progressive degenera on of photoreceptors or re nal pigment epithelial (RPE) complex. This results in focal deposi on of acellular, polymorphous debris in between the re nal pigment epithelium and Bruch's membrane in and around macula which is known as drusen.[4,5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
