title: [The Granada Diabetic Retinopathy Study. Direct screening of 8,244 patients. I].
abstract: OBJECTIVE
  To evaluate the results of regular screening for diabetic retinopathy in the geographic area assigned to the San Cecilio University Hospital of Granada.
  
  
  METHODS
  A multicenter prospective cohort study was carried out over a 2-year follow-up period. Retinal examinations were performed in 8244 diabetics in 14 health centres. 11,924 retinal examinations using an indirect ophthalmoscope, following pupil dilatation, were carried out. The classification of the lesions was as recommended by the simplified international scale of diabetic retinopathy and macular edema. The intervals between fundus examinations followed those recommended by the ETDRS.
  
  
  RESULTS
  The crude prevalence of diabetes in the health area concerned was 2.77%. The average screening compliance of the program was 84.1%, and in only 0.3% of the patients was the fundus ophthalmoscopy ungradable. 91.3% of the known diabetic population attended for at least one fundus examination, with only 3.4% of the patients being referred for hospital treatment. The annual cost of the program was set at 53,173 Euros, with the average cost of each examination (6000 per year) being 8.87 Euros.
  
  
  CONCLUSIONS
  The Diabetic Retinopathy Screening Program (through dilated pupils) carried out with indirect ophthalmoscopy is cost-effective. It provides coverage to the whole known diabetic population with a high level of compliance. The percentage of patients whose fundus can be considered ungradable is minimal.
authors.affiliation: Hospital Universitario San Cecilio, Servicio de Oftalmología, Granada, Spain. jopalace@hotmail.com
authors.forename: J L
authors.initials: JL
authors.lastname: García-Serrano
authors.forename: D
authors.initials: D
authors.lastname: Serrano-Laborda
authors.forename: M
authors.initials: M
authors.lastname: López-Pozas
authors.forename: C
authors.initials: C
authors.lastname: Cabello-Aparicio
authors.forename: L
authors.initials: L
authors.lastname: Castro-Rosales
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology*; D005654:Fundus Oculi; D006801:Humans; D008403:Mass Screening / Q000191:economics; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D009887:Ophthalmoscopy; D015995:Prevalence; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology