Screening diabetic retinopathy in Burgundy with an itinerant nonmydriatic camera

Introduction: The aim of this study was to assess the suitability of screening diabetic retinopathy (DR) with an itinerant nonmydriatic camera. Methods: This program required collaboration between ophthalmologists and general practitioners. Three professional organizations gave their support: L'union Professionnelle des Medecins Liberaux de Bourgogne (UPMLB), le Fonds d'Aide a la Qualite des Soins de Ville (FAQSV), et la Federation des Associations des Diabetiques de Bourgogne (FADB). The screening program took place from November 2004 to June 2005 throughout the Burgundy region. General practitioners, health professionals (pharmacists, nurses), local media, and health insurance offices informed patients of the DR screening. An orthoptist took photographs with a nonmydriatic digital camera. Each patient had four fundus photographs without pupillary dilatation. Photographs were analyzed in the Department of Ophthalmology of Dijon's General Hospital. Results: In this study, 676 diabetic patients were screened. Among these patients, 58 had DR, exclusively nonproliferative retinopathies. Nine percent of the photographs were ungradable. The mean age of patients with DR was 65 years. The mean onset of diabetes was 18 years before the study. Insulin therapy was followed by 27 patients (46.6%). Hemoglobin A1c was known in 26 patients (44.8%), with a mean value of 8.14%. Nearly 60% of patients with DR did not have their recommended annual consultation. After screening, 84% of patients consulted an ophthalmologist. Conclusion: Screening DR with an itinerant nonmydriatic camera can improve ophthalmologic follow-up of diabetics in rural areas. This screening program has continued in 2006 with an adapted vehicle.