title: The use of digital cameras in a mobile retinal screening environment.
abstract: OBJECTIVE
  To assess how successfully digital camera technology might be incorporated into a mobile screening environment.
  
  
  METHODS
  One hundred and ninety-seven people had their fundi photographed using a Topcon/Imagenet digital system and 534 using a Canon CR5/Ris-Lite system in addition to concurrent 45 degrees CR4NM Polaroid photography. One hundred and eighteen randomly selected patients were also sent for 7 field stereo photography as a gold standard. An acceptability questionnaire was answered by a random sample of those photographed.
  
  
  RESULTS
  For the detection of any retinopathy, digital pictures had a sensitivity of 0.74 (95% confidence interval (CI) 0.68-0.80) whilst Polaroid was 0.72 (95% CI 0.66-0.78) and for referable retinopathy digital pictures had a sensitivity of 0.85 (95% CI 0.80-0.90) and Polaroid was 0.90 (95% CI 0.86-0.94). A concurrent ophthalmoscopic evaluation improved the sensitivity to 0.92 (95% CI 0.86-0.98) for detection of any retinopathy whilst the sensitivity at the referral level was improved to 0.95 (95% CI 0.91-0.99). Twenty-nine of 176 respondents experienced flash discomfort with the Polaroid system with only four of 154 describing 'some' discomfort from the digital systems which have a lower flash power (10 W vs. 300 W) and a faster recovery time.
  
  
  CONCLUSIONS
  This study indicates that digital systems are a feasible and acceptable alternative to Polaroid-based cameras for use in a mobile environment.
authors.affiliation: Department of Diabetes and Vascular Medicine, School of Postgraduate Medicine and Health Sciences, University of Exeter, Wonford, UK. eyescreen@compuserve.com
authors.forename: D J
authors.initials: DJ
authors.lastname: Taylor
authors.forename: J
authors.initials: J
authors.lastname: Fisher
authors.forename: J
authors.initials: J
authors.lastname: Jacob
authors.forename: J E
authors.initials: JE
authors.lastname: Tooke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000517:prevention & control*; D016001:Confidence Intervals; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000453:epidemiology; D004739:England / Q000453:epidemiology; D005260:Female; D005451:Fluorescein Angiography / Q000295:instrumentation; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D008952:Mobile Health Units; D012680:Sensitivity and Specificity