title: The Nonmydriatic Fundus Camera in Diabetic Retinopathy Screening: A Cost-Effective Study with Evaluation for Future Large-Scale Application.
abstract: Aims. The study aimed to present the experience of a screening programme for early detection of diabetic retinopathy (DR) using a nonmydriatic fundus camera, evaluating the feasibility in terms of validity, resources absorption, and future advantages of a potential application, in an Italian local health authority.Methods. Diabetic patients living in the town of Ponzano, Veneto Region (Northern Italy), were invited to be enrolled in the screening programme. The "no prevention strategy" with the inclusion of the estimation of blindness related costs was compared with screening costs in order to evaluate a future extensive and feasible implementation of the procedure, through a budget impact approach.Results. Out of 498 diabetic patients eligible, 80% was enrolled in the screening programme. 115 patients (34%) were referred to an ophthalmologist and 9 cases required prompt treatment for either proliferative DR or macular edema. Based on the pilot data, it emerged that an extensive use of the investigated screening programme, within the Greater Treviso area, could prevent 6 cases of blindness every year, resulting in a saving of €271,543.32 (-13.71%).Conclusions. Fundus images obtained with a nonmydriatic fundus camera could be considered an effective, cost-sparing, and feasible screening tool for the early detection of DR, preventing blindness as a result of diabetes.
authors.affiliation: Department of Ophthalmology, Ca Foncello Hospital, ULSS 9 TREVISO, 31100 Treviso, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Scarpa
authors.affiliation: Department of Ophthalmology, Ca Foncello Hospital, ULSS 9 TREVISO, 31100 Treviso, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Urban
authors.affiliation: Department of Ophthalmology, University of Padova, 35122 Padova, Italy.
authors.forename: Stela
authors.identifier: 0000-0001-6773-9967
authors.initials: S
authors.lastname: Vujosevic
authors.affiliation: General Management, Ca Foncello Hospital, ULSS 9 TREVISO, 31100 Treviso, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Tessarin
authors.affiliation: General Management, Ca Foncello Hospital, ULSS 9 TREVISO, 31100 Treviso, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gallo
authors.affiliation: Primary Care Physicians Coordinating Body, Ca Foncello Hospital, ULSS 9 TREVISO, 31100 Treviso, Italy.
authors.forename: Annalisa
authors.identifier: 0000-0003-4288-0707
authors.initials: A
authors.lastname: Visentin
authors.affiliation: Centre for Research on Health Economics, Social and Health Care Management (CREMS), LIUC-Università Cattaneo, 21053 Castellanza, Italy.
authors.forename: Emanuela
authors.identifier: 0000-0003-1381-9069
authors.initials: E
authors.lastname: Foglia
authors.affiliation: Centre for Research on Health Economics, Social and Health Care Management (CREMS), LIUC-Università Cattaneo, 21053 Castellanza, Italy.
authors.forename: Lucrezia
authors.identifier: 0000-0002-8561-898X
authors.initials: L
authors.lastname: Ferrario
authors.affiliation: Department of Ophthalmology, University of Padova, 35122 Padova, Italy; Fondazione G. B. Bietti, IRCCS, Roma, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Midena