Evaluation of a System for Automatic Detection of Diabetic Retinopathy From Color Fundus Photographs in a Large Population of Patients With Diabetes

We read with interest the recent article by Abramoff et al.(1) but were disappointed in their conclusion that automated grading software could not be recommended for clinical practice. Our group's published work (2) shows that automated grading of diabetic retinopathy, based on image-quality assessment and microaneurysm detection, can safely reduce the burden of grading in diabetic retinopathy screening programs. Comparing manual and automated grading against a reference standard grading of 14,406 images (from 6,722 patients), we found that our automated system attained a higher sensitivity for detection of patients requiring “full disease” grading than the …