Abstract
Abstract: :
Purpose: The main aim of this study is to evaluate a new diabetic retinopathy (DR) screening by eye fundus photographs taken by a non–mydriatic retinograph compared to a dilated eye exam by an ophthalmologist. Methods:Two networks of general practitioners (GPs) (control group= ARES 92, experimental group = Réseau de Santé Paris Nord) were recruited on voluntary basis from each network. Each group was to enroll 500 patients based on the following inclusion criterion: patients with diabetes but without documented DR or a dilated eye exam performed within the last year. The experimental group was referred to the retinograph for eye fundus photographs without pupil dilation. The control group was referred directly to an ophthalmologist for a dilated eye exam. The photographs, taken by an orthoptist, were transmitted electronically to a central analysis department and read by an ophthalmologist (Lariboisière Hospital). The main criterion of screening evaluation was the existence of an eye fundus exam report in the GP file after the 6 months of follow up. Results: Physician participation percentage was 35,4% in the Paris Nord Network and 12,1% in the ARES 92 network. Respectively, 456 and 426 patients were included in the experimental group and the control group. 39 patients (23 of which did perform the eye fundus photography) from the PARIS–NORD group and 9 from the ARES 92 group were lost by the GPs in the follow–up period. Among the 417 patients included in the Paris Nord group, the physician did receive the report of the Topcon photography examination for 309 patients (74.1%). Among these patients, 49 (15.9%) were affected by DR, of which 15 (4.9%) were in an unrecognized severe stage of DR, while 16 (5.2%) patients had results that were non–interpretable. In the control group, the physician received the ophthalmologist report for 298 (71.5%) patients in the 6–month follow–up period. Among these patients, 31 (10.4%) were affected by DR, of which 22 (7.3%) were in a severe stage. Conclusions: The screening of DR by a non–mydriatic camera, performed in an organized network, can be an effective means for identifying and staging DR.
Keywords: diabetic retinopathy • detection • imaging/image analysis: clinical