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RESEARCH PRODUCT

Balance Sheet of Screening for Diabetic Retinopathy With a Mobile Non-Mydriatic Digital Camera in Burgundy, France

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Purpose: To assess the economic balance-sheet of screening for diabetic retinopathy (DR) with a mobile non-mydriatic digital camera in Burgundy, France, in a public health and economic perspective.Methods: The 72 lowest medicalised areas of Burgundy were visited. Retinal images were obtained with a non-mydriatic camera. To construct an economic model, we used available data on the prevalence of diabetes in Burgundy, the efficiency of the screening, the number of screened DR, blindness probability according to DR grading, the efficiency of laser therapy, the diabetic characteristics (gender, age, income, professional status and life expectancy) and medical costs induced by our campaign.Results: 3363 diabetics (mean age: 70±11 years) have had an ocular examination for more than 2 years and only 2547 patients were declared eligible (previous medical examination by an ophthalmologist more than 2 years and no RD previously known according to the patient). Among the 3363 patients, only 3 treatable DR and 25 macular oedemas were found. Among eligible patients, neither treatable DR nor macular oedema was found. If we consider only the financial analysis, results showed a cost overrun per patient from Social Security perspective (cost: 97±248 euros; saving i.e. avoided contributions: 49±580 euros) and from societal perspective (cost: 112±57 euros; saving, i.e. avoided loss of income: 6±177 euros).Conclusions: Our study showed the unfavourable balance-sheet of our DR screening sessions. However these results need to be considered in an overall improvement of the quality of life.