{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:37:20Z","timestamp":1790642240882,"version":"4.1.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,3,1]],"date-time":"2020-03-01T00:00:00Z","timestamp":1583020800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Telemedicine and e-Health"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Early diagnosis and prompt therapy of diabetic retinopathy (DR) are essential to prevent visual loss, but access of the diabetic population to regular fundus examination by an ophthalmologist remains a challenge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This prospective comparative study, including two referral health centers in the state of Minas Gerais, Southeastern Brazil, assesses applicability and economic viability of fundus photography-based teleophthalmology screening for DR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 2,662 eyes of 1,331 patients were examined at both health centers. Mean age was 57 years, with 836 (62.8%) females. Quality of fundus photographs was acceptable for 2,398 eyes (90.1%). The presence of DR was disclosed in 394 patients (29.6%), with 28 patients (2.1%) presenting evidence of advanced disease (severe nonproliferative or proliferative DR). Economic assessment revealed cost reduction of 28.76 US$ per patient, with a calculated break-even point of 112 exams\/month or 1,344 exams\/year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>For the situation studied under the perspective of public health service, teleophthalmology was viable and cost effective when compared with ordinary ophthalmology examination. In addition, teleophthalmology allowed rapid resolution of repressed demand for fundus examination of diabetic patients locally at the two sites, with early DR diagnoses and referrals. Fundus photography-based teleophthalmology was a viable, effective, and significantly cheaper strategy for the screening of DR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/tmj.2018.0241","type":"journal-article","created":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T10:40:25Z","timestamp":1555497625000},"page":"341-346","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":25,"title":["Teleophthalmology Screening for Diabetic Retinopathy in Brazil: Applicability and Economic Assessment"],"prefix":"10.1177","volume":"26","author":[{"given":"Grazielle Fialho de","family":"Souza","sequence":"first","affiliation":[{"name":"Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato Minelli","family":"Figueira","sequence":"additional","affiliation":[{"name":"Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Beatriz","family":"Alkmim","sequence":"additional","affiliation":[{"name":"Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidiane Aparecida Pereira de","family":"Sousa","sequence":"additional","affiliation":[{"name":"Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Bonisson","sequence":"additional","affiliation":[{"name":"Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio Luiz Pinho","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Vitor","family":"Vasconcelos-Santos","sequence":"additional","affiliation":[{"name":"Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,3,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.9.1414"},{"key":"e_1_3_3_3_2","unstructured":"Vigitel Brazil 2016. Surveillance of risk and protective factors for chronic diseases by telephone survey: Estimates of sociodemographic frequency and distribution of risk and protective factors for chronic diseases in the capitals of the 26 Brazilian states and the Federal District in 2016. Editora MS\u2013OS 2017\/0229. Available at http:\/\/portalarquivos.saude.gov.br\/images\/pdf\/2017\/junho\/07\/vigitel_2016_jun17.pdf (last accessed April9 2019)."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9136(1998120)15:4 <S47::AID-DIA739>3.0.CO;2-S"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001250051594"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2008.08.023"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(13)38011-7"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199309303291401"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)07019-6"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.08.022"},{"key":"e_1_3_3_11_2","unstructured":"American Academy of Ophthalmology Retina\/Vitreous Panel. Preferred practice pattern guidelines. Diabetic retinopathy. 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