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Flore De Bats, Christiane Vannier Nitenberg, Bruno Fantino, Laurent Kodjikian; « DODMLA » : Organized screening of age-related macular degeneration by delayed reading of retinophotography. Invest. Ophthalmol. Vis. Sci. 2013;54(15):251.
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Age-related macular degeneration (AMD) is the first cause of severe visual impairment in elderly in industrialized countries. The early stages of AMD can be diagnosed by retinophotography and thus receive efficient prevention. The aim of our study was to assess the interest and the feasibility of AMD ’s screening in over 65 years old patients using telemedicine transmitted and interpreted retinophotography .
Non mydriatic retinography was proposed to all the 65 years old and over participants completing a periodic health check up in a Regional Insurance Center between 02/01/2012 and 11/13/2012. Participant with a known AMD were excluded from the study. After obtaining their informed consent, a retinophotography on both eyes was made by a trained nurse. A risk factors questionnaire of this disease (sex, age, family history of AMD, iris color, smoking, cataract surgery) was administered by the nurse. The images were electronically transmitted and interpreted by an ophthalmologist of Croix-Rousse hospital University in Lyon.
A retinophotography was proposed to 866 consultants. 584 participants (67,4 %) were included with a majority of men (52,1 %). The mean age was of 72 years [± 5,72]. The causes of not inclusions were : refusal to participate (15,1 %), impossibility to perform the exam (7 %), no obtention of the consent (9,2 %), presence of a known AMD (1,2 %). Photos were no interpretable in 21,4 % of cases. So 458 photos were treated and 22,27 % were abnormal. Concerning the right eye, 38 (8 %) presented a stage 1, 26 (5,47 %) a stage2, 8 (1,68 %) a stage 3 and 2 (0,42 %) an atrophic stage 4. Concerning the left eye 36 (7,87 %) presented a stage 1, 22 (4,81 %) a stage 2, 9 (1,96 %) a stage 3 and 2 (0,43 %) an atrophic stage 4. No exsudative AMD was found. The presence of abnormalities was correlated to familial history of AMD (OR=2,94 [1,2-7,22]) or to cataract surgery past history (OR= 1,96 [ 1,04-3,71 ]). The mean age increased with the stage of the AMD.
Our results confirm the interest and feasibility of retinophotography in AMD screening for over 65 years old participants. Age, familial history of AMD or familial history of cataract surgery were identified as risk factors.
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