title: The potential of digital monochrome images versus colour slides in telescreening for diabetic retinopathy.
abstract: We explored the potential of digital monochrome images as an alternative to colour slides in screening for diabetic retinopathy. Twenty-eight patients with diabetes were recruited for the study and 20 actually participated. Using a fundus camera (Nikon 505AF) one set of three digital images and one set of three colour slides were taken per eye. Two independent ophthalmologists graded the colour slides and the digital images for diabetic retinopathy. The ophthalmologists spent about two minutes grading each set of images, suggesting that specialists could potentially screen a large number of patients. The agreement between the two screening methods was 0.95 and 0.89, with respect to disease or no disease. The agreement (kappa) between the two ophthalmologists for grade of retinopathy was 0.47 when colour slides were employed and 0.61 when digital monochrome images were employed. The results indicate that digital red-free monochrome images represent a superior screening tool for diabetic retinopathy. Tele-screening may be beneficial when patients have to travel substantial distances to visit an ophthalmologist.
authors.affiliation: Norwegian Centre for Telemedicine, University Hospital of North Norway, Tromsø, Norway. monika.johansen@telemed.no
authors.forename: Monika Alise
authors.initials: MA
authors.lastname: Johansen
authors.forename: Kristian
authors.initials: K
authors.lastname: Fossen
authors.forename: Jan
authors.initials: J
authors.lastname: Norum
authors.forename: Terje
authors.initials: T
authors.lastname: Christoffersen
authors.forename: Håkon
authors.initials: H
authors.lastname: Oritsland
authors.forename: Daniel
authors.initials: D
authors.lastname: Haga
authors.forename: Per
authors.initials: P
authors.lastname: Hasvold
authors.forename: Johan Gustav
authors.initials: JG
authors.lastname: Bellika
authors.forename: Undine
authors.initials: U
authors.lastname: Knarvik
authors.forename: Steinar
authors.initials: S
authors.lastname: Pedersen
mesh_terms: D000328:Adult; D000368:Aged; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009885:Ophthalmology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017216:Telemedicine / Q000379:methods*