Aiello L M, Bursell S E, Cavallerano J, Gardner W K, Strong J
Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, USA.
J Am Optom Assoc. 1998 Nov;69(11):699-710.
This preliminary study is designed to evaluate the quality of initial images obtained using the Joslin Vision Network (JVN) image capture and retrieval system.
Digitized images of 18 patients (36 eyes) were obtained using Topcon Non-mydriatic Fundus Camera and various imaging protocols as described for each series of images. Level of retinopathy ranged from no diabetic retinopathy to proliferative diabetic retinopathy. Images were reviewed and evaluated in comparison to medical record notes and Early Treatment Diabetic Retinopathy Study (ETDRS) seven-standard field stereoscopic 35-mm retinal fundus photographs--when available--to determine the ability of JVN digitized images to allow appropriate diagnosis and clinical management. JVN images were also evaluated for presence of photographic artifacts and stereoscopic presentation. The various displays and relative value of each JVN display were also evaluated.
Using combinations of JVN image displays, JVN images were shown to match diagnosed level of diabetic retinopathy as determined from record notes and/or ETDRS seven-standard field stereoscopic 35-mm retinal fundus photography. Viewing images with various combinations of JVN image displays delineates possible sources of artifacts in JVN images. Areas to guide future image capture and image reading are identified.
The JVN image capture system and reading of images by certified readers should allow appropriate photodiagnostic information to support the JVN, the diabetes mellitus disease management telemedicine initiative of the Joslin Diabetes Center. A rigid, full-scale, masked study to compare the Joslin Vision Network to seven-standard field stereoscopic 35-mm retinal fundus photography should be pursued to validate the image-gathering and image-reading strategy to support the Joslin Vision Network.
本初步研究旨在评估使用乔斯林视觉网络（JVN）图像采集与检索系统获取的初始图像质量。
使用拓普康免散瞳眼底相机及针对各系列图像所描述的各种成像方案，获取了18例患者（36只眼）的数字化图像。视网膜病变程度从无糖尿病视网膜病变到增殖性糖尿病视网膜病变不等。将图像与病历记录以及早期糖尿病性视网膜病变研究（ETDRS）七标准视野立体35毫米视网膜眼底照片（如有）进行对比审查和评估，以确定JVN数字化图像进行适当诊断和临床管理的能力。还对JVN图像的摄影伪像和立体呈现情况进行了评估。同时评估了JVN的各种显示方式及其相对价值。
通过JVN图像显示方式的组合，JVN图像显示出与根据病历记录和/或ETDRS七标准视野立体35毫米视网膜眼底摄影确定的糖尿病视网膜病变诊断水平相匹配。通过JVN图像显示方式的各种组合查看图像，可确定JVN图像中可能的伪像来源。确定了指导未来图像采集和图像解读的领域。
JVN图像采集系统以及由经过认证的阅片者对图像进行解读，应能提供适当的光诊断信息，以支持JVN，即乔斯林糖尿病中心的糖尿病疾病管理远程医疗计划。应开展一项严格的、全面的、盲法研究，将乔斯林视觉网络与七标准视野立体35毫米视网膜眼底摄影进行比较，以验证支持乔斯林视觉网络的图像采集和图像解读策略。
