title: Six-year prevalence and incidence of diabetic retinopathy and cost-effectiveness of tele-ophthalmology in Manitoba.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the diabetic retinopathy (DR) tele-ophthalmology screening program in Manitoba to determine prevalence and incidence of DR, as well as to estimate the program's cost-effectiveness.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  A total of 4676 patients with type 2 diabetes examined 9334 times from 2007 to 2013.
  
  
  METHODS
  Focused ophthalmic histories were recorded and examinations were performed by trained nurses, including visual acuities, intraocular pressure, and mydriatic 7 standard field stereoscopic fundus photography. Images were evaluated by retinal specialists according to the Early Treatment of Diabetic Retinopathy Study criteria. DR prevalence and incidence were then calculated during the study period. Cost-effectiveness was estimated by comparing the cost of running the tele-ophthalmology program compared with the cost of screening the same volume of patients in-office.
  
  
  RESULTS
  The average prevalence of any DR in each year was 25.1%. The cumulative incidence of DR across 6 years was 17.1% (95% CI, 15.4%-18.7%). The average savings per tele-ophthalmology examination was $1007.
  
  
  CONCLUSIONS
  DR is highly prevalent among the studied population. Tele-ophthalmology provides a cost-effective means of monitoring patients as well as identifying new or treatable disease.
authors.affiliation: Department of Ophthalmology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba.. Electronic address: kanjeer@myumanitoba.ca.
authors.forename: Raageen
authors.initials: R
authors.lastname: Kanjee
authors.affiliation: Department of Ophthalmology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba.
authors.forename: Ravi I
authors.initials: RI
authors.lastname: Dookeran
authors.affiliation: Department of Ophthalmology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba.
authors.forename: Mathen K
authors.initials: MK
authors.lastname: Mathen
authors.affiliation: Department of Ophthalmology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba.
authors.forename: Frank A
authors.initials: FA
authors.lastname: Stockl
authors.affiliation: Department of Ophthalmology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba.
authors.forename: Richard
authors.initials: R
authors.lastname: Leicht
mesh_terms: D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D008297:Male; D008350:Manitoba; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D015397:Program Evaluation; D012189:Retrospective Studies; D017216:Telemedicine / Q000191:economics*