Accessible linux distro for raspberry pi?

[Linux for blind general discussion]

I'm not sure what you mean by setup screen in this context, but as far
as I know, Stormux is the only Raspberry Pi image that's actively
maintained and comes pre-loaded with blind accessibility already
setup.

That said, several users have had success setting up espeakup or
Ffenrir on CLI-only images from several distros over ssh, and recent
versions of Raspbian's full images are supposed to have a keyboard
shortcut for enabling Orca(though reviews are mixed on how well this
works and how well Orca works with the Raspberry Foundation's Pixel
skin of LXDE, though people have reported successfully getting Orca
running with Mate on higher ram models of the Pi 4.

You might also want to check out the Raspberry VI website and mailing
list, which are dedicated to blind accessibility on the Pi and double
as a general low-vision hobby electronics blog and mailing list.