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J. Beynat, S. Arnavielle, M. Soulie-Strougar, A. Charles, K. Astruc, P. Metral, A. M. Bron, C. Creuzot-Garcher; Screening for Diabetic Retinopathy in a Rural Population With an Itinerant Non-Mydriatic Camera. Invest. Ophthalmol. Vis. Sci. 2007;48(13):165.
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The aim of this study was to evaluate the yield of diabetic retinopathy (DR) screening in a rural population with an itinerant non-mydriatic camera.Patients and
1974 diabetics were screened between 2005 and 2006: 676 the first year and 1298 the second. The 72 lowest medicalised areas of Burgundy were visited. An orthoptist performed fundus photographies with a Topcon’s TRC-NW200 non-mydriatic camera (4 fields: posterior pole, nasal, temporal and upper). The photographies analysis was performed in the department of Ophthalmology, according to the International Clinical Diabetic Disease Severity Scale. The private ophthalmologists agreed to receive the positive or doubtful patients within one month.
On the 1974 screened patients, 103 presented a DR (5.2%), including 70 mild non-proliferative DR (68%), 21 moderate non-proliferative DR (20.4 %), and 12 severe non-proliferative DR (11.6%). The rate of non interpretable photographies was 27.6%.The average age of the patients with a DR was 67.5 (27 to 94). The average onset of the diabetes was 16.5 years. Insulinic treatment was founded in 48 patients (46.6%) and 35 were aware of there HbA(1c) (34%) with an average of 7.8%. Lastly, 19 have had an ophthalmologic visit within one year before screening (18.4%), 38 between 1 and 2 years (36.9%), 28 more than 2 years (27.2%) and 10 more than 5 years (9.7%); 7 had never seen an ophthalmologist (6.8%).Discussion:The average cost due to the organization of the screening was 142 euros per patient. The proportion of positive screening was 5.2%.More half of the patients presenting a RD did not have the recommended annual eye visit. The majority of the detected RD were non-proliferative forms, which may benefit from a preventive treatment or a monitoring.
This screening improves the quality of the ocular follow-up of the diabetics in rural area. The increase of the number of patients per meeting as well as a better recruitment would improve the medical and economic performances of the future campaigns.
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