Aims To assess how successfully digital camera technology might be incorpor
ated into a mobile screening environment.
Methods One hundred and ninety-seven people had their fundi photographed us
ing a Topcon/Imagenet digital system and 534 using a Canon CR5/Ris-Lite sys
tem in addition to concurrent 45 degrees CP4NM Polaroid photography. One hu
ndred and eighteen randomly selected patients were also sent for 7 field st
ereo photography as a gold standard. An acceptability questionnaire was ans
wered by a random sample of these photographed
Results For the detection of any retinopathy, digital pictures had a sensit
ivity of 0.74 (95% confidence interval (CI) 0.68-0.80) whilst Polaroid was
0.72 (95% CI 0.66-0.78) and for referable retinopathy digital pictures had
a sensitivity of 0.85 (95% CI 0.80-0.90) and Polaroid was 0.90 (95% CI 0.86
-0.94). A concurrent ophthalmoscopic evaluation improved the sensitivity to
0.92 (95% CI 0.86-0.98) for detection of any retinopathy whilst the sensit
ivity at the referral level was improved to 0.95 (95% CI 0.91-0.99). Twenty
-nine of 176 respondents experienced flash discomfort with the Polaroid sys
tem with only four of 154 describing 'some' discomfort from the digital sys
tems which have a lower flash power (10 W vs. 300 W) and a faster recovery
time.
Conclusions This study indicates that digital systems are a feasible and ac
ceptable alternative to Polaroid-based cameras for use in a mobile environm
ent.