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Detecting Age-Related Macular Degeneration: Technologies Are Best Compared When Standardized

Detecting Age-Related Macular Degeneration: Technologies Are Best Compared When Standardized Klein et al1 compared gradings of lesions associated with age-related macular degeneration from digital and stereoscopic film images. Their data showed that retinal pigment epithelium depigmentation and detachment “were less likely to be graded as present” in digital images compared to film even in dilated pupils. We share the authors’ views regarding the need to standardize parameters particularly when comparing results from different systems. Standardizing all variables, such as luminance, Kelvin temperature, distance, and angle of view, is critical to set a platform that allows objective comparison between film and digital capture. Not paying attention to these details may bias results. The authors did not specify in this study the kind of monitor used to view digital images, its resolution, nor whether its luminance was matched to the light box used for grading film-based images. This is particularly relevant when grading subtle retinal pigment epithelium changes where contrast is of essence. Light-box luminance is significantly higher than that of a computer monitor. Matching luminance is critical for a standardized comparison. There is also no mention of the distance and angle of view from the computer monitor and their effects on relative magnification. The impact of these issues on the authors’ findings is unknown. The American Telemedicine Association (Washington, DC) has issued recommendations for equipment specifications and for image acquisition and analysis. They are useful in studies validating different imaging systems. We agree that standardization and development of guidelines for using digital images is important, particularly should multicenter studies start using different digital imaging systems. Just as we carefully select film and processing, we must pay similar attention to the properties of the digital display. Correspondence: Dr Khouri, Ophthalmology and Visual Sciences, University of Medicine and Dentistry of New Jersey, 90 Bergen St, Suite 6100, Newark, NJ 07130 (albert.khouri@umdnj.edu). References 1. Klein RMeuer SMMoss SEKlein BENeider MWReinke J Detection of age-related macular degeneration using a nonmydriatic digital camera and a standard film fundus camera. Arch Ophthalmol 2004;1221642- 1646PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Detecting Age-Related Macular Degeneration: Technologies Are Best Compared When Standardized

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References (1)

Publisher
American Medical Association
Copyright
Copyright © 2005 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.123.8.1157-a
Publisher site
See Article on Publisher Site

Abstract

Klein et al1 compared gradings of lesions associated with age-related macular degeneration from digital and stereoscopic film images. Their data showed that retinal pigment epithelium depigmentation and detachment “were less likely to be graded as present” in digital images compared to film even in dilated pupils. We share the authors’ views regarding the need to standardize parameters particularly when comparing results from different systems. Standardizing all variables, such as luminance, Kelvin temperature, distance, and angle of view, is critical to set a platform that allows objective comparison between film and digital capture. Not paying attention to these details may bias results. The authors did not specify in this study the kind of monitor used to view digital images, its resolution, nor whether its luminance was matched to the light box used for grading film-based images. This is particularly relevant when grading subtle retinal pigment epithelium changes where contrast is of essence. Light-box luminance is significantly higher than that of a computer monitor. Matching luminance is critical for a standardized comparison. There is also no mention of the distance and angle of view from the computer monitor and their effects on relative magnification. The impact of these issues on the authors’ findings is unknown. The American Telemedicine Association (Washington, DC) has issued recommendations for equipment specifications and for image acquisition and analysis. They are useful in studies validating different imaging systems. We agree that standardization and development of guidelines for using digital images is important, particularly should multicenter studies start using different digital imaging systems. Just as we carefully select film and processing, we must pay similar attention to the properties of the digital display. Correspondence: Dr Khouri, Ophthalmology and Visual Sciences, University of Medicine and Dentistry of New Jersey, 90 Bergen St, Suite 6100, Newark, NJ 07130 (albert.khouri@umdnj.edu). References 1. Klein RMeuer SMMoss SEKlein BENeider MWReinke J Detection of age-related macular degeneration using a nonmydriatic digital camera and a standard film fundus camera. Arch Ophthalmol 2004;1221642- 1646PubMedGoogle ScholarCrossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Aug 1, 2005

Keywords: technology,age-related macular degeneration

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