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Acta Ophthalmol Scand. 2000 Apr;78(2):164-8.

Colour slides or digital photography in diabetes screening--a comparison.

Author information

1
Department of Ophthalmology, Helsingborg Hospital, Sweden. m.henricsson@angelholm.mail.telia.com

Abstract

PURPOSE:

The aim of this study was to compare digital images with slides in detecting and grading diabetic retinopathy, and to assess the retinopathy screening performed by ophthalmic nurses.

METHOD:

283 consecutive patients were examined using digital colour and redfree photography (Topcon Imagenet System 1.53) and 35 mm slides (Topcon TRC-50 VT fundus camera, Kodachrome 64 colour film). The images were graded by the worst eye according to the Wisconsin classification by an ophthalmologist and ophthalmic nurse independently.

RESULTS:

There was exact agreement between grades obtained from the colour slides and the digital colour images in 82% (weighted kappa 0.88; 95% CI 0.80-0.96), and in 85% when redfree images were used as an adjunct to the digital colour images There was a tendency towards undergrading of the digital colour images and overgrading of the digital redfree images, compared with the colour slides. Inter- and intragrader agreement (weighted kappa) varied between 0.77 and 0.84 for digital photography and between 0.88 and 0.90 for colour slides

CONCLUSION:

Good to excellent agreement was found between the grading of colour slides and digital colour images, the latter, however, associated with a slightly lower reliability. The adjunct of redfree images seemed to facilitate the detection of retinopathic lesions.

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