title: OPHDIAT: a telemedical network screening system for diabetic retinopathy in the Ile-de-France.
abstract: OBJECTIVE
  International and national guidelines recommend an annual funduscopic examination for all diabetic patients, but such annual fundus examinations are not sufficiently performed in France. Non-mydriatic fundus photography is a valid method of evaluation for diabetic retinopathy (DR) and a viable alternative to ophthalmoscopy. After two pilot studies demonstrated the feasibility of telemedical screening for diabetic retinopathy in both hospital and primary-care settings, we developed a regional telemedical network, OPHDIAT, designed to facilitate access to regular annual evaluations of patients with diabetes while saving medical time.
  
  
  METHODS
  OPHDIAT comprises peripheral screening centres equipped with non-mydriatic cameras, where fundus photographs are taken by technicians linked by telemedicine to a reference centre, where ophthalmologists grade the images. Currently in the Ile-de-France region, 16 screening centres are linked through a central server to an ophthalmologic reading centre and includes 11 centres located in the diabetes departments of 11 hospitals, one diabetic retinopathy screening centre located in northern Paris, three in healthcare centres and one in a prison.
  
  
  RESULTS
  During the 28-month evaluation period, 15,307 DR screening examinations were performed. Retinal photographs of at least one eye could not be graded in 1332 patients (9.7%) and diabetic retinopathy was detected in 3350 patients (23.4%). After the screening examination, 3478 patients (25.2%) were referred to an ophthalmologist for either DR, cataract and/or non-gradable photographs.
  
  
  CONCLUSIONS
  Fundus photography combined with telemedicine has the potential to improve the regular annual evaluation for diabetic retinopathy. The organization of the network around a central reading centre serves to guarantee quality control.
authors.affiliation: Ophthalmology department, hôpital Lariboisière, université Paris-VII, Assistance publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France. p.massin@lrb.aphp.fr
authors.forename: P
authors.initials: P
authors.lastname: Massin
authors.forename: A
authors.initials: A
authors.lastname: Chabouis
authors.forename: A
authors.initials: A
authors.lastname: Erginay
authors.forename: C
authors.initials: C
authors.lastname: Viens-Bitker
authors.forename: A
authors.initials: A
authors.lastname: Lecleire-Collet
authors.forename: T
authors.initials: T
authors.lastname: Meas
authors.forename: P-J
authors.initials: PJ
authors.lastname: Guillausseau
authors.forename: G
authors.initials: G
authors.lastname: Choupot
authors.forename: B
authors.initials: B
authors.lastname: André
authors.forename: P
authors.initials: P
authors.lastname: Denormandie
mesh_terms: D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000453:epidemiology*; D005260:Female; D006296:Health Services; D006761:Hospitals; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D010297:Paris / Q000453:epidemiology; D010821:Physicians, Family; D011330:Prisons; D017216:Telemedicine