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Detection of diabetic retinopathy: a comparison between red-free digital images and colour transparencies

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Abstract

Background

The aim of this study was to compare how diabetic retinopathy was detected from red-free digital images and colour transparencies.

Methods

Two ophthalmologists graded two-field, nonstereoscopic, 60° red-free digital images and colour transparencies utilizing an ETDRS-based grading scale, from 107 mainly type 2 diabetic patients. The discordantly scored eyes were graded by the graders together to obtain a consensus level of retinopathy for each method. The eyes with discordant consensus grading results were further graded using all available photographic material to reach a final consensus level of diabetic retinopathy. Intermethod variations were presented as percentages and using kappa (k) and weighted kappa (wk) statistics. The errors of the two consensus gradings with respect to the final consensus grading were compared using McNemar’s test.

Results

For the colour transparencies there was an agreement between the individual and the consensus grading results in 93% (k=0.90, wk=0.97) and 86% (k=0.79, wk 0.88) for grader 1 and grader 2. Corresponding figures for red-free digital images were 88% (k=0.83, wk=0.96) and 84% (k=0.78, wk 0.91). Agreement between methods was obtained in 76/107 eyes (71%; k=0.58 and wk=0.79). In the 31 discordantly graded eyes the level of retinopathy was underestimated in 20/31 (64%) vs 7/31 eyes (23%) and overestimated in 1/31 (3%) vs 3/31 eyes (10%) from colour transparencies and red-free digital images, respectively. The error tendencies were significantly lower when using red-free digital images (p<0.008).

Conclusions

Red-free digital images are comparable with two-field colour transparencies in the identification of mild to moderate nonproliferative diabetic retinopathy.

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Acknowledgements

This work was supported by grants from the Eye Foundation, Finland and Helsinki University Central Hospital Research Fund (TYH 3263), Finland, and the foundation Stiftelsen Synfrämjandets Forskningsfond, Sweden.

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Authors and Affiliations

  1. Department of Vitreoretinal Diseases, St Eriks Eye Hospital, Polhemsgatan 50, 112 82, Stockholm, Sweden

    Gunvor von Wendt, Peep Algvere & Stefan Seregard

  2. Department of Ophthalmology, Örnsköldsvik Hospital, Örnsköldsvik, Sweden

    Kerstin Hallnäs

  3. Department of Ophthalmology, Helsinki University Central Hospital, Helsinki, Finland

    Paula Summanen

  4. Department of Public Health, Helsinki University, Helsinki, Finland

    Kauko Heikkilä

Authors
  1. Gunvor von Wendt
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  2. Paula Summanen
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  3. Kerstin Hallnäs
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  4. Peep Algvere
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  5. Kauko Heikkilä
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  6. Stefan Seregard
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Correspondence to Gunvor von Wendt.

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von Wendt, G., Summanen, P., Hallnäs, K. et al. Detection of diabetic retinopathy: a comparison between red-free digital images and colour transparencies. Graefe's Arch Clin Exp Ophthalmol 243, 427–432 (2005). https://doi.org/10.1007/s00417-004-1068-7

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  • DOI: https://doi.org/10.1007/s00417-004-1068-7

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