Tele-transmission of stereoscopic images of the optic nerve head in glaucoma via Internet.

The objective was to describe an inexpensive system to visualize stereoscopic photographs of the optic nerve head on computer displays and to transmit such images via the Internet for collaborative research or remote clinical diagnosis in glaucoma. Stereoscopic images of glaucoma patients were digitized and stored in a file format (joint photographic stereoimage [jps]) containing all three-dimensional information for both eyes on an Internet Web site (www.trizax.com). The size of jps files was between 0.4 to 1.4 MB (corresponding to a diagonal stereo image size between 900 and 1400 pixels) suitable for Internet protocols. A conventional personal computer system equipped with wireless stereoscopic LCD shutter glasses and a CRT-monitor with high refresh rate (120 Hz) can be used to obtain flicker-free stereo visualization of true-color images with high resolution. Modern thin-film transistor-LCD displays in combination with inexpensive red-cyan goggles achieve stereoscopic visualization with the same resolution but reduced color quality and contrast. The primary aim of our study was met to transmit stereoscopic images via the Internet. Additionally, we found that with both stereoscopic visualization techniques, cup depth, neuroretinal rim shape, and slope of the inner wall of the optic nerve head, can be qualitatively better perceived and interpreted than with monoscopic images. This study demonstrates high-quality and low-cost Internet transmission of stereoscopic images of the optic nerve head from glaucoma patients. The technique allows exchange of stereoscopic images and can be applied to tele-diagnostic and glaucoma research.