Screening for diabetic retinopathy in a rural French population with a mobile non-mydriatic camera

Aim. - The aim of this study was to evaluate the yield of diabetic retinopathy (DR) screening in a rural population using a mobile non-mydriatic camera. Methods. - The 72 least medicalized areas of Burgundy were the target areas. An orthoptist took fundus photographs using a Topcon TRC-NW6S non-mydriatic camera (four fields: posterior pole nasals temporal: and upper). Interpretations were done in the Department of Ophthalmology according to the classification of the French Language Association for the Study of Diabetes and Metabolic Diseases (Alfediam). Results. - Between 2004 and 2006, 1974 diabetics were screened-676 the first year, and 1298 in the second. The rate of non-interpretable photographs was 13%. Of the 1974 screened patients, there were 103 cases of DR (5.2%), comprising 70 mild non-proliferative DR (68%), 21 moderate non-proliferative DR (20.4%) and 12 severe non-proliferative DR (11.6%). The mean age of the patients with a DR was 66.7 +/- 10.9 years, with a mean duration of diabetes of 16.5 +/- 9.8 years. Only 35 (34%) patients were aware of their HbA(1c), which had a mean value of 7.8% and 19 had visited an ophthalmologist in the year before screening (18.4%). After the initial screening, 90.5% of the patients consulted an ophthalmologist as recommended. Conclusion. - Screening improved the quality of the ocular follow-up in diabetics in this rural area. However, improvements in management are needed to lower the cost of such a programme. (C) 2008 Elsevier Masson SAS. All rights reserved.