title: Methods and limits of digital image compression of retinal images for telemedicine.
abstract: OBJECTIVE
  To investigate image compression of digital retinal images and the effect of various levels of compression on the quality of the images.
  
  
  METHODS
  JPEG (Joint Photographic Experts Group) and Wavelet image compression techniques were applied in five different levels to 11 eyes with subtle retinal abnormalities and to 4 normal eyes. Image quality was assessed by four different methods: calculation of the root mean square (RMS) error between the original and compressed image, determining the level of arteriole branching, identification of retinal abnormalities by experienced observers, and a subjective assessment of overall image quality. To verify the techniques used and findings, a second set of retinal images was assessed by calculation of RMS error and overall image quality.
  
  
  RESULTS
  Plots and tabulations of the data as a function of the final image size showed that when the original image size of 1.5 MB was reduced to 29 KB using JPEG compression, there was no serious degradation in quality. The smallest Wavelet compressed images in this study (15 KB) were generally still of acceptable quality.
  
  
  CONCLUSIONS
  For situations where digital image transmission time and costs should be minimized, Wavelet image compression to 15 KB is recommended, although there is a slight cost of computational time. Where computational time should be minimized, and to remain compatible with other imaging systems, the use of JPEG compression to 29 KB is an excellent alternative.
authors.affiliation: Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Nedlands. robeik@cyllene.uwa.edu.au
authors.forename: R H
authors.initials: RH
authors.lastname: Eikelboom
authors.forename: K
authors.initials: K
authors.lastname: Yogesan
authors.forename: C J
authors.initials: CJ
authors.lastname: Barry
authors.forename: I J
authors.initials: IJ
authors.lastname: Constable
authors.forename: M L
authors.initials: ML
authors.lastname: Tay-Kearney
authors.forename: L
authors.initials: L
authors.lastname: Jitskaia
authors.forename: P H
authors.initials: PH
authors.lastname: House
mesh_terms: D006801:Humans; D012161:Retinal Artery / Q000473:pathology*; D012164:Retinal Diseases / Q000208:ethnology / Q000473:pathology*; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation; D019113:Telepathology / Q000379:methods*; D014904:Western Australia / Q000453:epidemiology