La télémédecine pour le dépistage de la rétinopathie diabétique

Despite improvements in the management of diabetic patients and the efficacy of laser photocoagulation, diabetic retinopathy (DR) remains a major cause of visual impairment and blindness in France. This is mainly due to a too late diagnosis of DR. In an effort to detect DR at an early stage before visual loss, international and national guidelines for DR' screenings were developed, which recommend annual fundus examination for all diabetic patients. In France, a recent survey showed that approximately 50% of diabetic patients only had had an eye examination during the previous year. Fundus photography is a method, at least as sensitive, as ophthalmoscopy for the detection of DR. New nonmydriatic cameras and digital photography may allow a network organization of multiple screening centers around a central ophthalmological reading center where digital images can be transmitted. Such organization has been implemented in Île-de-France, it comprises 28 screening centers, and, since 2004, more than 51,000 screening exams have been performed. In addition, automated systems for screening of DR are being developed, and may improve in the future, the efficacy of this new screening organization.