Impact of a Mobile Screening of Diabetic Retinopathy in a French Rural Population

Abstract

Purpose: : The aim of this study is to evaluate the evolution of the diabetic retinopathy (DR) screening with a mobile non-mydriatic camera in a rural population two years after the first campaign.

Methods: : Since November 2004, three DR screening campaigns were carried out in Burgundy’s rural areas. The 37 areas of the third one were identical to the first one. Screening methodology remained identical. Patients were screened by a trained orthoptist. Four 45° non-stereoscopic images of 4 fields were taken for each eye: one image was centred on the macula, and one each on the nasal, temporal and superior fields. DR status was evaluated according to the classification of the Association of French Language for the Study of the Diabetes and the Metabolic Diseases in the department of ophthalmology by trained fellows.

Results: : In 2004, for the first campaign 676 patients were screened. In 2006, for the third one, we have screened 1369 diabetics. The proportion of detected DR increased in a non significant way (8.6% (n=58) versus (vs) 10.5% (n=143); p=0.17). Proportions of mild non-proliferative (NP) (56.9% vs 64.3%; p=0.32) and moderate NPDR (24.1% vs 29.4%; p=0.44) was stable. We detected less severe NPDR (15.5% vs 4.2%; p=0.006). The proportion of patients aware of their glycated haemoglobin (HbA1c) decreased (41.4% vs 37.9%; p<0.0001), but the average of HbA1c was better (7.4±1.2% vs 7.15±1.3%; p=0.0004). The mean duration of diabetes was stable (11.0±10.3 years vs 10.5±9.3 years; p=0.91). The proportion of diabetics treated by insulin decreased significantly (21.4% vs 13.3%; p<0.0001). The number of patients having had an ophthalmic consultation within the year before the campaign increased from 4.5% to 16.4% (p<0.0001). The number of unreadable images fell in a non significant way (9% vs 7.6%; p=0.27).

Keywords: diabetic retinopathy