Abstract: Objective To assess the cost-effectiveness of fundus photography-based primary open angle glaucoma (POAG) screening which will provide evidence for the development of open angle glaucoma screening strategy in community. Design Cost-effectiveness analysis. Participants The epidemiological results about Beijing Eye Study and Handan Eye Study. Methods Based on the epidemiological investigation results of POAG in Beijing Eye Study and Handan Eye Study, the disability-adjusted life years (DALY) attibuting to POAG was calculated between two modles of population-based POAG screening and case-opportunity diagnosis using R software. At the same time, direct costing for two models, including the cost of screening, diagnosis, intervention, was compared. Main Outcome Measures  Direct costing, DALY. Results  Assuming patients with POAG among 10 000 population aged 40 years and above can be screened every 5 years, the incidence of visual function damage is 30% which is lower than that of case-opportunity diagnosis (50%). The direct cost for population based screening of POAG was estimated 1 750 000 Yuan which is lower than that of hospital medical mode (4 060 000 Yuan). Strikingly, DALY attributing to POAG for population-based screeing (1.33) is lower than that of hospital medical mode (2.76). Conclusion Population-based screening for POAG can reduce DALY due to POAG, decrease the risk of visial function demage, improve the quality of life, and save the direct medical cost.

Key words: primary open angle glaucoma, community screening, fundus photography, cost-effectiveness