Comparative Evaluation of Oculometric Variables in Graves’ Ophthalmopathy

Miot, Hélio Amante; Fernandes, Leonardo Parr dos Santos; Jorge, Edson Nassib; Pivotto, Daniel Rosito; Nogueira, Célia Regina; Mazeto, Gláucia Maria Ferreira da Silva

doi:10.1590/s1807-59322009000900009

Cited by 10 publications

(11 citation statements)

References 19 publications

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“…Miot et al obtained multiple photographic measurements of eyelid position relative to points on the eye, and compared these to clinical exophthalmometry. 9 The only measurements for which there was a correlation were the distance of the lateral limbus to the lateral canthus, and the distance from the superior limbus to the lateral canthus. 9 Based on available data, vertical and horizontal palpebral fissure measurements should not be used to estimate AGP.…”

Section: Discussionmentioning

confidence: 99%

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Axial Globe Position Measurement

Bingham

Sivak-Callcott

Gurka

et al. 2016

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose Identify a reproducible measure of axial globe position (AGP) for multicenter studies of patients with thyroid eye disease (TED). Methods This is a prospective, international, multicenter, observational study in which 3 types of AGP evaluation were examined: radiologic, clinical, and photographic. In this study, computed tomography (CT) was the modality to which all other methods were compared. CT AGP was measured from an orthogonal line between the anterior lateral orbital rims to the cornea. All CT measurements were made at a single institution by 3 individual clinicians. Clinical evaluation was performed with exophthalmometry. Three clinicians from each clinical site assessed AGP with 3 different exophthalmometers and horizontal palpebral width using a ruler. Each physician made 3 separate measurements with each type of exophthalmometer, not in succession. All photographic measurements were made at a single institution. AGP was measured from lateral photographs in which a standard marker was placed at the anterior lateral orbital rim. Horizontal and vertical palpebral fissure were measured from frontal photographs. Three trained readers measured 3 separate times, not in succession. Exophthalmometry and photography method validity was assessed by agreement with CT (mean differences calculation, ICC’s, Bland-Altman figures). Correlation between palpebral fissure and CT AGP was assessed with Pearson correlation. Intraclinician and interclinician reliability was evaluated using intraclass correlation coefficients (ICC). Results Sixty-eight patients from 7 centers participated. CT mean AGP was 21.37mm (15.96 – 28.90mm) right, 21.22mm (15.87 – 28.70mm) left (ICC 0.996 and 0.995). Exophthalmometry AGP fell between 18mm and 25mm. Intraclinician agreement across exophthalmometers was ideal (ICC 0.948 – 0.983). Agreement between clinicians was greater than 0.85 for all upright exophthalmometry measurements. Photographic mean AGP was 20.47mm (10.92 – 30.88mm) right, 20.30mm (8.61 – 28.72mm) left. Intrareader and interreader agreement was ideal (ICC 0.991 – 0.989). All exophthalmometers’ mean differences from CT ranged between −0.06mm (+/− 1.36mm) and 0.54mm (+/− 1.61mm); 95% CI fell within 1mm. Magnitude of AGP did not affect exophthalmometry validity. Oculus best estimated CT AGP but differences form other exophthalmometers were not clinically meaningful in upright measurements. Photographic AGP (right ICC=0.575, left ICC=0.355) and palpebral fissure do not agree with CT. Conclusions Upright clinical exophthalmometry accurately estimates CT AGP in TED. AGP measurement was reliably reproduced by the same clinician and between clinicians at multiple institutions using the protocol in this study. These findings allow reliable measurement of AGP that will be of considerable value in future outcome studies.

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Section: Discussionmentioning

confidence: 99%

“…Although CT, MRI, and eyelid correlation measurements have been used to assess AGP, exophthalmometry is most commonly reported and most familiar to clinicians. 2,9,10,11,12,13,14 Exophthalmometer design and user technique affect accuracy and reproducibility. 3,16, 25 Interobserver variability is common.…”

Section: Discussionmentioning

confidence: 99%

Axial Globe Position Measurement

Bingham

Sivak-Callcott

Gurka

et al. 2016

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…Digital exophthalmometry is a recent method to measure the axial globe position. Some authors using photography to evaluate palpebral position have reported good results in patients with Graves Orbitopathy [9,10]. e upsides of using photography instead of CT or Hertel exophthalmometry are noninvasiveness and high availability.…”

Section: Discussionmentioning

confidence: 99%

“…Digital photography is a simple, noninvasive method of measurement, with the additional advantage that measurements are documented and the images are easily shared online. Photographic techniques have been used to evaluate palpebral position, [9,10] but to our knowledge, only one previous study has compared the methods of photography, clinical exophthalmometry, and CT in the measurement of exophthalmos.…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study of Clinical vs. Digital Exophthalmometry Measurement Methods

Pereira

Kuniyoshi

Leite

et al. 2020

Journal of Ophthalmology

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Background. A number of orbital diseases may be evaluated based on the degree of exophthalmos, but there is still no gold standard method for the measurement of this parameter. In this study we compare two exophthalmometry measurement methods (digital photography and clinical) with regard to reproducibility and the level of correlation and agreement with measurements obtained with Computerized Tomography (CT) measurements. Methods. Seventeen patients with bilateral proptosis and 15 patients with normal orbits diseases were enrolled. Patients underwent orbital CT, Hertel exophthalmometry (HE) and standardized frontal and side facial photographs by a single trained photographer. Exophthalmometry measurements with HE, the digital photographs and axial CT scans were obtained twice by the same examiner and once by another examiner. Pearson correlation coefficient (PCC) was used to assess correlations between methods. Validity between methods was assessed by mean differences, interintraclass correlation coefficients (ICC’s), and Bland–Altman plots. Results. Mean values were significantly higher in the proptosis group (34 orbits) than in the normal group (30 orbits), regardless of the method. Within each group, mean digital exophthalmometry measurements (24.32 ± 5.17 mm and 18.62 ± 3.87 mm) were significantly greater than HE measurements (20.87 ± 2.53 mm and 17.52 ± 2.67 mm) with broader range of standard deviation. Inter-/intraclass correlation coefficients were 0.95/0.93 for clinical, 0.92/0.74 for digital, and 0.91/0.95 for CT measurements. Correlation coefficients between HE and CT scan measurements in both groups of subjects (r = 0.84 and r = 0.91, p<0.05) were greater than those between digital and CT scan measurements (r = 0.61 and r = 0.75, p<0.05). On the Bland–Altman plots, HE showed better agreement to CT measurements compared to the digital photograph method in both groups studied. Conclusions. Although photographic digital exophthalmometry showed strong correlation and agreement with CT scan measurements, it still performs worse than and is not as accurate as clinical Hertel exophthalmometry. This trail is registered with NCT01999790.

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“…The first of the filters is pixel resolution in the original image; we filter out iris images where the width of the iris, in pixels, in the original image is smaller than approxi-mately 45 pixels as discussed below. We base this criterion on results from IREX-IX [4] which showed a stable FNMR down to iris diameter of approximately 40 pixels 5 . We can compute the horizontal extent of the palpebral fissure, the distance between the medial and lateral canthi, for each iris, from the annotations described above.…”

Section: Iris Image Extraction and Match Score Generationmentioning

confidence: 99%

Analysis of iris images in Nicholas Nixon: the Brown sisters

Matey¹,

Grother²,

Quinn³

2020

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Certain commercial entities, equipment, software or materials may be identified in this document in order to describe an experimental procedure or concept adequately. Such identification is not intended to imply recommendation or endorsement by the National Institute of Standards and Technology (NIST), nor is it intended to imply that the entities, materials, software or equipment are necessarily the best available for the purpose.

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Comparative Evaluation of Oculometric Variables in Graves’ Ophthalmopathy

Cited by 10 publications

References 19 publications

Axial Globe Position Measurement

Axial Globe Position Measurement

A Comparative Study of Clinical vs. Digital Exophthalmometry Measurement Methods

Analysis of iris images in Nicholas Nixon: the Brown sisters

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