title: [Evaluation of diabetic retinopathy screening using non-mydriatic fundus camera performed by physicians' assistants in the endocrinology service].
abstract: BACKGROUND
  Since 2010, the High Authority for health (HAS) recommends the use of non-mydriatic fundus camera for diabetic retinopathy screening. The purpose of this study is to evaluate the results of screening for diabetic retinopathy using the non-mydriatic retinal camera by a physician's assistant in the endocrinology service.
  
  
  METHODS
  This is a retrospective study of all diabetic patients hospitalized in the endocrinology department between May 2013 and November 2013. For each endocrinology patient requiring screening, a previously trained physician's assistant performed fundus photos. The ophthalmologist then provided a written interpretation of the photos on a consultant's sheet.
  
  
  RESULTS
  Of the 120 patients screened, 40 (33.3%) patients had uninterpretable photos. Among the 80 interpretable photos, 64 (53.4%) patients had no diabetic retinopathy, and 16 (13.3%) had diabetic retinopathy. No patient had diabetic maculopathy.
  
  
  CONCLUSIONS
  Specific quality criteria were established by the HAS for screening for diabetic retinopathy using the non-mydriatic retinal camera in order to ensure sufficient sensitivity and specificity. In our study, the two quality criteria were not achieved: the rates of uninterpretable photos and the total number of photos analyzed in a given period.
  
  
  CONCLUSIONS
  In our center, we discontinued this method of diabetic retinopathy screening due to the high rate of uninterpretable photos. Due to the logistic impossibility of the ophthalmologists taking all the fundus photos, we proposed that the ophthalmic nurses take the photos. They are better trained in the use of the equipment, and can confer directly with an ophthalmologist in questionable cases and to obtain pupil dilation as necessary.
authors.affiliation: Service d'ophtalmologie, CHU de Caen, avenue de la Côte-de-Nacre, 14003 Caen, France.
authors.forename: M-G
authors.initials: MG
authors.lastname: Barcatali
authors.affiliation: Service d'ophtalmologie, CHU de Caen, avenue de la Côte-de-Nacre, 14003 Caen, France.
authors.forename: E
authors.initials: E
authors.lastname: Denion
authors.affiliation: Service d'ophtalmologie, CHU de Caen, avenue de la Côte-de-Nacre, 14003 Caen, France.
authors.forename: S
authors.initials: S
authors.lastname: Miocque
authors.affiliation: Service d'endocrinologie, CHU de Caen, avenue de la Côte-de-Nacre, 14003 Caen, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Reznik
authors.affiliation: Service d'endocrinologie, CHU de Caen, avenue de la Côte-de-Nacre, 14003 Caen, France.
authors.forename: M
authors.initials: M
authors.lastname: Joubert
authors.affiliation: Service d'endocrinologie, CHU de Caen, avenue de la Côte-de-Nacre, 14003 Caen, France.
authors.forename: J
authors.initials: J
authors.lastname: Morera
authors.affiliation: Service d'endocrinologie, CHU de Caen, avenue de la Côte-de-Nacre, 14003 Caen, France.
authors.forename: A
authors.initials: A
authors.lastname: Rod
authors.affiliation: Service d'ophtalmologie, CHU de Rennes, rue Henri-Le-Guilloux, 35000 Rennes, France. Electronic address: frederic.mouriaux@chu-rennes.fr.
authors.forename: F
authors.initials: F
authors.lastname: Mouriaux
mesh_terms: D003930:Diabetic Retinopathy / Q000175:diagnosis*; D003941:Diagnostic Techniques, Ophthalmological; D004704:Endocrinology; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008875:Middle Aged; D009184:Mydriatics; D010823:Physician Assistants; D011996:Records; D012189:Retrospective Studies
chemical_list: D009184:Mydriatics
keywords: Aide-soignant(e); Diabetic; Diabète; Dépistage; Physicians’ assistants; Retinopathy; Rétinopathie; Screening