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T. Tran, J. Rahmoun, F. Denimal, A. Hui Bon Hoa, F. Delecourt; Screening for Diabetic Retinopathy Using a Three-Field Digital Non Mydriatic Fundus Camera. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4428.
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To estimate the prevalence of diabetic retinopathy, using three-field digital photography in patients with diabetes mellitus in a general hospital where ophthalmologist is not available.
Patients from Endocrinology department of Saint Philibert hospital were screened consecutively from March 2007 to September 2008. Demographic and clinical data including date of birth, gender, type of diabetes, HbA1 c and albuminuria were recorded. Three 45° digital images per eye examinations were taken using a non-mydriatique fundus camera by a technician without dilatation and sent to the Department of Ophthalmology of Saint Vincent de Paul for grading by two ophthalmologists.
A total of 1147 adults patients (52% males, 48% females) were included. Median age was 60 years (19-108). Most patients were type 2 diabetes (n= 1028, 90%). Mean HbA1c was 8%. Albuminuria was detected in 239 patients (20.8%). Of these 1147 patients, 521 (45%) said they never have had fundus examination previously. Retinal photograph of at least one eyes could not be graded in 172 patients (15%). Diabetic retinopathy was detected in 185 patients (19%). Suspected macular edema (hard exsudate within one disc diameter of the macular center) was found in 75 eyes (3,2%). Referral to an ophthalmologist was required in 356 patients (31%) for diabetic retinopathy and ungradable photographs.
Non-mydriatic photography, combined with telemedicine improve the screening of diabetic retinopathy and allow the identification of patients requiring further complete eye examination.
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