Rudnisky Christopher J, Tennant Matthew T S, Weis Ezekiel, Ting Andrew, Hinz Bradley J, Greve Mark D J
Department of Ophthalmology, University of Alberta, Edmonton, Canada.
Ophthalmology. 2007 Sep;114(9):1748-54. doi: 10.1016/j.ophtha.2006.12.010. Epub 2007 Mar 21.
To evaluate the ability of Joint Photographic Experts Group (JPEG) compressed, stereoscopic, digital photography to identify clinical levels of diabetic retinopathy, detect clinically significant macular edema (CSME), and make appropriate referral recommendations as compared with Early Treatment Diabetic Retinopathy Study (ETDRS) standard film photography.
Prospective, clinic-based, comparative photographic format validation study.
Two hundred four eyes from 102 consecutive, new, diabetic patients with a median duration of diabetes of 12.5 years were enrolled and analyzed.
After pupillary dilation, a trained ophthalmic photographer obtained 2 sets of images: standard ETDRS, stereoscopic 7-field 35-mm film photographs and high-resolution, digital images of the same 7 standard fields (stereoscopic images of fields 1 and 2). Two masked readers graded both sets of images. The 35-mm film photographs were graded by hand using a written template. Digital photographs were compressed, uploaded to a web site, and graded by a web-based, computer-assisted ETDRS algorithm. The ETDRS level of diabetic retinopathy, presence of retinal thickening, and referral recommendation based on these 2 diagnoses were recorded and compared.
The presence of CSME, ETDRS level of diabetic retinopathy, and referral threshold diabetic retinopathy.
Film and compressed digital grading levels were compared using a simplified ETDRS categorization scheme. Film and digital gradings were highly correlated with exact agreements for level of diabetic retinopathy, CSME, and referral thresholds >87% and kappa levels >0.71. McNemar's testing found no statistically significant difference between compressed digital images and film when comparing referral thresholds (defined as the presence of CSME and/or ETDRS level > or = 61; P = 0.76).
A modified ETDRS protocol (stereoscopic images of fields 1 and 2 only) with 16:1 JPEG image compression and computer-assisted ETDRS grading algorithm has excellent reproducibility when compared to standard ETDRS stereoscopic slide-film photography. An internet-based teleophthalmology system can correctly and reliably (kappa = 0.78) identify patients requiring referral for CSME and proliferative diabetic retinopathy (PDR; ETDRS level > or = 61).
评估联合图像专家组（JPEG）压缩的立体数码摄影技术与早期糖尿病性视网膜病变研究（ETDRS）标准胶片摄影相比，识别糖尿病视网膜病变临床分级、检测临床上显著的黄斑水肿（CSME）以及做出适当转诊建议的能力。
前瞻性、基于诊所的比较摄影格式验证研究。
连续纳入102例新诊断的糖尿病患者的204只眼，糖尿病病程中位数为12.5年，并进行分析。
瞳孔散大后，一名经过培训的眼科摄影师获取两组图像：标准ETDRS立体7视野35毫米胶片照片以及相同7个标准视野的高分辨率数码图像（视野1和2的立体图像）。两名阅片者对两组图像进行分级。35毫米胶片照片使用书面模板手工分级。数码照片进行压缩后上传至网站，并通过基于网络的计算机辅助ETDRS算法进行分级。记录并比较糖尿病视网膜病变的ETDRS分级、视网膜增厚情况以及基于这两种诊断结果的转诊建议。
CSME的存在情况、糖尿病视网膜病变的ETDRS分级以及转诊阈值糖尿病视网膜病变。
使用简化的ETDRS分类方案比较胶片和压缩数码分级水平。胶片和数码分级在糖尿病视网膜病变分级、CSME以及转诊阈值方面的完全一致性高度相关（>87%），kappa值>0.71。McNemar检验发现，比较转诊阈值时（定义为存在CSME和/或ETDRS分级≥61；P = 0.76），压缩数码图像与胶片之间无统计学显著差异。
与标准ETDRS立体幻灯片摄影相比，采用16:1 JPEG图像压缩和计算机辅助ETDRS分级算法的改良ETDRS方案（仅视野1和2的立体图像）具有出色的可重复性。基于互联网的远程眼科系统能够正确且可靠地（kappa = 0.78）识别需要转诊治疗CSME和增殖性糖尿病视网膜病变（PDR；ETDRS分级≥61）的患者。
Zotero 插件