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Application of telemedicine technique in screening for diabetic retinopathy

Ładyżyński P., Wójcicki J. M., Chihara K.

Biocybernetics and Biomedical Engineering

2007

Vol. 27, no. 1-2

253-263

Diabetic retinopathy is one of the most serious long-term microvascular complications of diabetes. It is a sight-threatening, chronic ocular disorder, which is currently the most common cause of blindness in people of working age in western societies. Slit lamp biomicroscopy and seven-field stereoscopic 30o fundus photography (with dilated pupil) represent the current gold standard techniques for detecting diabetic retinopathy. These methods are too expensive for widespread use in the screening process, even in the most developed countries. At present, retinopathy is usually detected by the direct ophthalmoscopic examination. Simple wide angle color fundus photography is another much more accurate and widely used method. The introduction of digital imaging cameras made the application of the telemedicine technique possible. First feasibility studies concerning application of the telemedicine technique in screening for diabetic retinopathy were reported in the late 1990s. These early systems used mobile fundus cameras or e-mail messages for transmission of digital fundus photographs between distant locations in a store–and–forward mode. Then, more advanced systems followed, which either based on proprietary software solutions or on the latest advances of the internet technology. One of such systems has been developed in co-operation between NAIST and IBBE PAS. The developed DRWeb system consists of the image acquisition station, the database and communication server and the image grading station. Two modes of operation are possible: telediagnosis – when all the mentioned above stages are conducted independently, one after another and teleconsultation – when real time interaction between the physician and the expert is possible. The system is supplemented by an algorithm ensuring that the quality of the transmitted digital images is good enough for a successful making of the diagnosis.