Sir,

The authors found good agreement for diabetic retinopathy (DR) detection between grading uncompressed tagged interchanged files format (TIFF) images taken with a nonmydriatic digital camera and their joint photographic experts group (JPEG) equivalents, compressed by JPEG2000 or classic JPEG algorithms. Both performed well for the detection of haemorrhages and microaneurysms (HMA), when preselected ‘good quality’ TIFF images were compressed at the lowest ratio. Our experience in the Gloucestershire Diabetic Eye Screening Service, using a Topcon TRNW5s camera and Sony DXC-950 tri-CCD colour video camera, producing TIFF images of identical resolution (800 × 600 pixels) is that it cannot reliably detect small DR lesions like HMA in the first place.

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