Digital fundus imaging: a quality and cost comparison with 35-mm film

Purpose: This study compares 35-mm transparencies with colour digital fundu s images. Methods: Colour fundus photos were acquired simultaneously on a digital sys tem and on 35-mm film on 32 consecutive patients. These were assessed indep endently by two ophthalmologists who graded overall picture quality and gra nularity of the images. They also assessed if the images were adequate for the purpose of making a diagnosis. An analysis of the costs of the two syst ems was performed. Results: The film images had significantly better scores for overall pictur e quality (p=0.0001, 95% CI 0.5 to 1.5) and granularity (p<0.0001, 95% CI 1 .5 to 2). However, both digital and film images were considered adequate fo r diagnosis (p=0.052, 95% CI 0.12 to 8.32). Conclusion: The quality of digital images is acceptable for diagnostic purp oses although resolution is limited. Other advantages and developing techno logies will make it increasingly attractive in the future.