Effect of Image Compression and Resolution on Retinal Vascular Caliber

Abstract

Changes in retinal vascular caliber measured from digital color fundus photographs have been independently associated with systemic outcomes in epidemiologic studies, but the effect of image resolution and compression on vascular measurements has not been previously evaluated. To explore image compression, 40 natively digital fundus images were selected with good photo quality, high spatial resolution, and no previous image compression. Using Adobe Photoshop, these images were compressed at progressively higher levels up to 147:1, and then retinal vascular caliber was measured at each level using semiautomated software. To examine resolution, 40 fundus photographs acquired on high-resolution film were scanned with settings corresponding to 10, 7, 5, 3, and 1 megapixel fundus cameras. After adjusting for scale factor, vascular caliber was measured at each level of resolution. Data were analyzed by comparing the calculated central retinal arteriole equivalent (CRAE) and the central retinal venular equivalent (CRVE) of the original and altered images, using repeated measures ANOVA. CRAE became significantly wider with increasing levels of compression at the 25:1 threshold (~1 μm wider, P < 0.001) and was ~5 μm wider with 147:1 compression. CRVE also increased, but less than CRAE. Using 7 (megapixel)-MP resolution as the standard, CRVE was significantly narrower at the 5-MP simulation (~2 μm, P < 0.001) and was ~12 μm narrower at the 1-MP simulation. CRAE also decreased, but less than CRVE. Increasing digital image file compression and decreasing fundus image spatial resolution led to skewed measurements of the retinal vascular caliber.