Preventive Eye Care in People With Diabetes Is Cost-Saving to the Federal Government: Implications for health-care reform

Javitt, Jonathan C.; Aiello, Lloyd Paul; Chiang, Yen-Pin; Ferris, Frederick L.; Canner, Joseph K.; Greenfield, Sheldon

doi:10.2337/diacare.17.8.909

Cited by 331 publications

(166 citation statements)

References 32 publications

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“…Facilities for a screening program involve equipment found in most eye clinics, including a slitlamp and a fundus camera. Javitt et al (1990Javitt et al ( , 1991Javitt et al ( , 1994Javitt et al ( , 1995Javitt et al ( , 1996 has tested the economic feasibility of diabetic screening. He tested 5 different screening models including dilated ophthalmoscopic examination every two years, every year or every six months with or without fundus photography.…”

Section: Figmentioning

confidence: 99%

“…It has been estimated that the assumed current 60% level of implementation of eye care in the US saves $348,9 million to the Federal budget and 101,360 person-years of sight. Each additional patient who enters a screening and treat- (Javitt et al 1994). In particular, 71.3% of blindness prevented among type 2 patients would result from macular edema (Javitt et al 1994).…”

Section: Socio-economic Aspectsmentioning

confidence: 99%

“…Each additional patient who enters a screening and treat- (Javitt et al 1994). In particular, 71.3% of blindness prevented among type 2 patients would result from macular edema (Javitt et al 1994). …”

Section: Socio-economic Aspectsmentioning

confidence: 99%

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Screening and prevention of diabetic blindness

Stefánsson

Bek

Porta

et al. 2000

Acta Ophthalmologica Scandinavica

251

180

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ABSTRACT. Diabetic eye disease remains a major cause of blindness in the world. Laser treatment for proliferative diabetic retinopathy and diabetic macular edema became available more than two decades ago. The outcome of treatment depends on the timing of laser treatment. The laser treatment is optimally delivered when high-risk characteristics have developed in proliferative retinopathy or diabetic macular edema and before this has significantly affected vision. Laser treatment is usually successful if applied during this optimal period whereas the treatment benefit falls sharply if the treatment is applied too late. In order to optimize the timing of laser treatment in diabetic eye disease screening programs have been established. The oldest screening program is 20 years old and several programs have been established during the last decade. In this paper the organisation and methods of screening programs are described including direct and photographic screening. The incidence and prevalence of blindness is much lower in populations where screening for diabetic eye disease has been established compared to diabetic populations without screening. Technical advantages may allow increased efficiency and telescreening. From a public health standpoint screening for diabetic eye disease is one of the most cost effective health procedures available. Diabetic eye disease can be prevented using existing technology and the cost involved is many times less than the cost of diabetic blindness.

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Section: Figmentioning

confidence: 99%

Section: Socio-economic Aspectsmentioning

confidence: 99%

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Screening and prevention of diabetic blindness

Stefánsson

Bek

Porta

et al. 2000

Acta Ophthalmologica Scandinavica

251

180

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“…The clinical benefit and cost-effectiveness of detection and appropriate treatment of diabetic retinopathy (DR) have been clearly demonstrated [1][2]. However, patient adherence to regular eye care is substantially less than optimal.…”

Section: Introductionmentioning

confidence: 99%

Nonmydriatic teleretinal imaging improves adherence to annual eye examinations in patients with diabetes

Conlin¹,

Fisch²,

Cavallerano³

et al. 2006

JRRD

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Abstract-We studied whether nonmydriatic digital retinal imaging with remote interpretation (teleretinal imaging) in the ambulatory care setting affected adherence to annual dilated eye examinations among patients with diabetes. We randomly assigned 448 patients to a teleretinal imaging group or a control group. We measured the number of patients who had dilated eye examinations within 12 months of group assignment and the agreement for level of diabetic retinopathy between teleretinal imaging and the eye examinations. The teleretinal imaging group (n = 223) had significantly more dilated eye examinations than the control group (n = 225). Teleretinal imaging and eye examination results showed significant correlation and moderate agreement. Cataract and smaller pupil size were significantly associated with ungradable retinal images. Two-thirds of patients with ungradable images had other ocular findings. Patients reported high satisfaction with nonmydriatic teleretinal imaging. Nonmydriatic teleretinal imaging improves diabetic retinopathy assessment rates.

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“…M acular oedema is a sight threatening complication of both type 1 and type 2 diabetes mellitus (Moss et al 1988) with a poorer visual outcome in type 2 diabetic patients (Javitt et al 1994). Laser treatment of clinically significant macular oedema is beneficial and reduces the overall risk of visual loss by about 50% (ETDRS No 9.1991).…”

mentioning

confidence: 99%