Integrating opportunistic ocular diseases screening into general health examination in Chinese: a multicentre study

Cost-effective screening models for ocular diseases in large populations remain a critical challenge for blindness prevention. Our preliminary study demonstrated the feasibility of opportunistic glaucoma screening integrated into general health examinations. This study aimed to evaluate the efficacy of this model for fundus disease screening in a multicentre, large-sample Chinese population.

This study was conducted in five health examination centres from four provinces of China. Chinese participants aged ≥18 years undergoing routine health examinations were invited to complete bilateral presenting visual acuity and non-mydriatic fundus photography. Fundus photography was assessed by two experienced graders. Proportion of fundus diseases/changes were calculated. Costs for the screening were also assessed.

A total of 63 935 eligible participants (age 45.4±14.0 years, 51.3% men) were enrolled. The top five diseases/changes were non-macular drusen (8.80%), macular degeneration (6.30%), glaucoma suspect (5.54%), epiretinal membrane (3.92%) and diabetic retinopathy (3.89%). The proportion of low vision and blindness in the total population was 5.85% and 0.15%, respectively. The top five diseases/changes with vision impairment were retinitis pigmentosa (18.18%), myopic retinopathy (16.52%), macular hole (11.76%), non-glaucomatous optic neuropathy (7.25%) and glaucomatous optic neuropathy (6.37%). The unit cost of screening a single case and an ocular disease suspect was US$22.2 (US$15.7 to US$26.7) and US$83.2 (US$58.7 to US$99.9), respectively.

This health examination centre-based screening model is feasible, effective and affordable for detecting multiple fundus diseases in large populations. As the model is promoted and its coverage expands, screening costs may be further reduced.