[Ophthalmology telemedicine at Rennes University Medical Center: Evaluation of the secure platform OMNIDOC during its first year of use]. / Télé-expertise en ophtalmologie au centre hospitalier universitaire de Rennes : évaluation de la plateforme sécurisée OMNIDOC au cours de sa première année d'utilisation.

INTRODUCTION: Ophthalmology as a specialty is a pioneer in the area of telemedicine. Remote consultation represents one of the 5 types of telemedicine services, with a growing volume of activity in university hospitals. In November 2020, the ophthalmology department of Rennes University Medical Center launched its remote consultation network with the secured platform OMNIDOC. The goal of this study was to assess its contribution during its first year of use. MATERIALS AND METHODS: Beginning in November 2020, ophthalmology consults at Rennes University Medical Center were directed towards the dedicated OMNIDOC network. Three-hundred and forty-one requests for remote consultation were received and analyzed between November 2020 and October 2021. We sent a satisfaction survey to both the requesting and consultant physicians to assess whether or not the network was beneficial. RESULTS: Three-hundred and twenty-seven remote consultations requested by 126 practitioners were included in the study. The median response time was 6hours. Every field of the specialty was involved, of which 22.3% were for pediatric patients under 6years of age. Among the requests, 89.7% were regional (Brittany) and came mostly from ophthalmologists (61.77%). Nearly one out of two patients did not require an in-person consultation at Rennes University Medical Center. DISCUSSION: The implementation of a remote consultation network allowed access to a rapid, facilitated medical ophthalmology consultation. Such a platform delivers safety and traceability of the interactions. It enhances and optimizes the patients' care pathway and encourages relationships with community physicians.

[Anterior orbital ischemia secondary to type 1 cryoglobulinemia: A case report and literature review]. / Ischémie du segment antérieur de l'œil secondaire à une cryoglobulinémie de type 1 : à propos d'un cas et revue de la littérature.

INTRODUCTION: Type 1 cryoglobulinemia is characterized by a large number of clinical signs. The lack of specificity of these signs can make diagnosis difficult. Ocular manifestations are rarely described across medical literature. Only 15 cases of ophthalmological involvement secondary to cryoglobulinaemia have been reported. COMMENT: We report the case of a 69-year-old patient with cutaneous type 1 cryoglobulinaemia. He presented with bilateral anterior segment ischemia without retinal involvement with unilateral neovascularisation. Treatment of the B lymphocyte clone with rituximab and bendamustine and plasma exchange were initiated with successfully. Two similar cases describing ischaemic damage to the iris during type 1 cryoglobulinemia have been reported in the literature. CONCLUSION: Irial ischaemia should be considered as a potential in type 1 cryoglobulinaemia.

[Validation of an ophtalmology tele-expertise protocol in nursing homes]. / Validation d'un protocole de téléexpertise d'ophtalmologie en EHPAD.

INTRODUCTION: Assisted living residents are a fragile population with limited access to health care. In recent years, telemedicine has developed in several specialties, including ophthalmology. The main objective of our study is the validation of an ophthalmology telemedicine protocol in assisted living facilities. MATERIALS AND METHODS: This is a retrospective, multicentric, descriptive study including 4 assisted living facilities in the Rennes area. An ophthalmic technician examined residents for one half-day per week. The examination was performed directly in the patient's room, in bed or in a chair, with portable equipment. An ophthalmologist from our service interpreted the results remotely on a deferred basis within 7 days. Appropriate medical or surgical care was then offered to the patient depending on the diagnosis. RESULTS: We included 113 residents. A complete, interpretable examination was achieved in 84.1% of cases. One or more ophthalmic conditions were diagnosed in 57.5% of the residents. Of the residents who were then seen at the university medical center, 65% underwent a scheduled surgical procedure or laser. Visual acuity was significantly improved subsequent to the telemedicine encounter. DISCUSSION: The success rate of a complete, interpretable examination allows us to now validate our nursing home examination procedure. In addition to bringing a large amount of initially unknown information to the medical and paramedical staff of the structure, ophthalmology telemedicine allows for a significant improvement in visual acuity. CONCLUSION: This project validated the feasibility of ophthalmology telemedicine in an assisted living setting. This protocol may also be applicable to other health care settings (penitentiaries, mental health institutions, etc.).