{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T16:43:04Z","timestamp":1791650584073,"version":"4.3.4"},"reference-count":38,"publisher":"Korean Ophthalmological Society","issue":"6","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ekjo.org"],"crossmark-restriction":true},"short-container-title":["Korean J Ophthalmol"],"published-print":{"date-parts":[[2025,12,5]]},"abstract":"<jats:p>Purpose: The purpose of this study was to evaluate economic aspect of diabetic retinopathy (DR) screening strategies in developing countries. It focused on the cost-effectiveness of artificial intelligence (AI) and telemedicine compared to standard care.Methods: A structured literature search was conducted using PubMed, ScienceDirect, the Cochrane Library, and Google Scholar. Studies were included if they involved patients with type 1 or type 2 diabetes mellitus, conducted in low- or middle-income countries at the time of the study, compared AI or telemedicine-based intervention with standard care, and performed a health economic assessment or provided sufficient data to assess cost-effectiveness.Results: Seven studies were identified from China, Thailand, Brazil, and India. Of these, four applied cost-utility analysis, two used cost-effectiveness analysis, and one employed both approaches. Three studies evaluated AI-based screening, three focused on telemedicine, and one examined a combined AI-assisted telemedicine model. All studies compared these interventions to standard care, with some using no screening as the comparator. Across all studies, AI and telemedicine-based screening strategies were found to be cost-effective, though the degree of economic benefit varied depending on the model, setting, and assumptions used.Conclusions: This review supports the cost-effectiveness and feasibility of AI- and telemedicine-based DR screening in developing countries. While most strategies proved economically viable, cost savings and health gains varied. 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