Comparative study of 3 exophthalmometers and computed tomographic biometry

Delmas, J.; Loustau, Jean-Marie; Martin, S; Bourmault, Loïc; Adenis, J.‐P.; Robert, Pierre-Yves

doi:10.5301/ejo.5001049

Cited by 16 publications

(12 citation statements)

References 17 publications

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“…They could not show an advantage of the parallex-free Mourits exophthalmometer [6]. On the other hand Genders et al as well as Delmas et al indicated good reliability for Mourits exophthalmometer [16, 17]. Further investigation is needed to prove the superiority of Mourits exophthalmometer regarding intra and interobserver reliability.…”

Section: Discussionmentioning

confidence: 99%

Association of anthropometric markers with globe position: A population-based MRI study

Schmidt

Kempin

Langner³

et al. 2019

PLoS ONE

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PurposeExophthalmometry is a common examination in ophthalmology. For example it is relevant for diagnosis or follow-up of thyroid eye disease. However, exophthalmometry is affected by several factors such as ethnicity, sex and age. The purpose of this study was to determine the globe position by magnetic resonance imaging (MRI) and to investigate its correlates among the general Northeast German adult population.MethodsA total of 3030 subjects aged between 20 and 89 from the population-based Study of Health in Pomerania (SHIP) underwent a standardised whole-body MRI. Axial length and globe position were determined in axial T1-weighted images of the orbit. The image had to include the corneal apex as well as the optic nerve head. Study participants were excluded from imaging analysis if there was no plane available that included both structures. Further exclusion criterion was a lateral deviation of the subject’s viewing direction. Images with inadequate quality due to motion artefacts or other technical reasons were excluded as well. Globe position was defined as the perpendicular distance between the interzygomatic line and the posterior surface of the cornea (exophthalmometric value). The distance between the posterior surface of the cornea and the posterior pole of the eyeball, at the boundary with orbital fat, was defined as axial length. We used posterior surface of the cornea for our measurements, because it seemed to be less vulnerable for motion artefacts than the anterior one. Moreover body measurements including body mass index (BMI), waist and hip circumferences were determined. Associations between anthropometric measurements with exophthalmometric outcomes were analysed by linear regressions adjusted for age and stratified by sex. P-values <0.05 were considered as statistically significant. To assess intra-reader variability intra-class correlation coefficients (ICC) were computed for repeated measurements of the MRI scans of 25 subjects.ResultsAfter considering the exclusion criteria 1926 evaluable subjects remained. There was no significant difference between means of right and left eyes. The mean exophthalmometric value was significantly higher in men (16.5 +/- 2.2 mm) than in women (15.3 +/- 2.1 mm). The mean MRI-axial length was 23.4 +/- 0.8 mm for men and 22.8 +/- 0.9 mm for women. BMI, waist and hip circumferences were positively correlated with exophthalmometric value (p<0.001). Difference of mean MRI-based exophthalmometric value for obese subjects (BMI ≥30 kg/m2) and non-overweight (BMI <25 kg/m2) was 2.1 mm for men and 1.6 mm for women. ICC between 0.97 and 0.99 indicate excellent repeatability of our method.ConclusionWe conclude that MRI-based exophthalmometric values are positively correlated with BMI, waist- and hip-circumference among the general Northeast German adult population. This association is independent from age and axial length. Consequently bodyweight of patients should be regarded to interpret exophthalmometric values correctly. MRI-exophthalmometry seems to be a suitable m...

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Section: Discussionmentioning

confidence: 99%

Association of anthropometric markers with globe position: A population-based MRI study

Schmidt

Kempin

Langner³

et al. 2019

PLoS ONE

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“…It suggests that the accuracies of three methods are comparative in measuring proptosis without any abnormity. Delmas et al 10 have demonstrated that CT has the same accuracy with Hertel exophthalmometer, but the simple Pythagorean theorem has not been reported yet.…”

Section: Discussionmentioning

confidence: 98%

“…However, the CT is gold standard in measuring proptosis and the Hertel exophthalmometer is commonly used in clinical work. 10,19 The measurement of proptosis by simple Pythagorean theorem has not been reported yet. Our study shows that its accuracy is comparable to CT measurement and Hertel exophthalmometer in normal people.…”

Section: Discussionmentioning

confidence: 99%

The feasibility analysis of calculating proptosis by simple Pythagorean theorem

Zhang

Zeng

Huang

et al. 2020

European Journal of Ophthalmology

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Purpose: We propose a new method to analyze the feasibility of calculating proptosis on the basis of simple Pythagorean theorem. Method: This is a non-inferiority trial, and the registration number is ChiCTR1900026490. The absolute value of proptosis of two eyes of patients without eye injury or diseases visiting our clinic from December 2017 to June 2019 was measured by computed tomography, Hertel exophthalmometer, and by simple Pythagorean theorem. With the application of MedCalc software version 19.0.4, the differences between these methods in two eyes were showed by Bland and Altman plot. Results: A 95% limit of agreement between computed tomography and Hertel exophthalmometer is −0.7 to 0.62 mm in right eye proptosis. A total of 4.44% (4/90) points were outside 95% limit of agreement. Similarly, the same method was used to compare the proptosis between computed tomography and other ways. We also compared the proptosis measured by homolateral and heterolateral simple Pythagorean theorem method in order to find out the consistence between them. The points in all Bland and Altman plots were lower than 5%, which means that the results of comparison between any two methods had a good consistency in the measurement of proptosis of both eyes. Conclusion: Pythagorean theorem can be applied to evaluate proptosis and has a good consistency comparing with computed tomography and the Hertel exophthalmometer. The method can be used for measuring proptosis of unilateral orbital, maxillofacial trauma, and dysplasia accurately. It is practical in clinical use of proptosis assessment because of its accuracy, reliability, and simplicity.

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“…It suggested that the accuracies of two methods are comparative in measuring proptosis without any abnormity. Delmas et al has demonstrated that CT has the same accuracy with Hertel exophthalmometer [8], but the Heron's formula has not been reported yet.…”

Section: Discussionmentioning

confidence: 99%

The feasibility analysis of calculating proptosis by simple Heron’s formula

et al. 2020

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We propose a new method to calculate proptosis by using the simple Heron's formula and analyze its feasibility. MethodIt was a none-inferiority trial. The registration number was ChiCTR1900026490. The absolute value of proptosis in 120 eyes, 60 patients without eye injury or diseases, was measured by computed tomography (CT) and simple Heron's formula. We did regression analysis and analyzed the differences between the two methods with Medcalc software version 19.0.4. The result was showed by Passing-Bablok regression analysis diagram and Bland and Altman plot. ResultsThe Passing-Bablok showed that the result of proptosis measured by CT and simple Heron's formula showed good positive correlation. A 95% limit of agreement in proptosis between CT and Heron's formula method was -0.46 to 0.54 mm in right eye and -0.45 to 0.46 mm in left eye. 1.66% (1/60) point was outside 95% LoA in both eyes. Moreover, a 95% limit of agreement between CT and Heron's formula method was -0.42 to 0.56 mm in difference of both eyes. 3.33% (2/60) points were outside 95% LoA. The points in all Bland and Altman plots were lower than 5%. It means that the results of comparison between the two methods had a good consistency in the measurement of proptosis. ConclusionsHeron's formula could be applied to calculate proptosis and has a good consistency compared with computed tomography (CT). This method is practical in proptosis assessment because of its accuracy, reliability and simplicity.

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Comparative study of 3 exophthalmometers and computed tomographic biometry

Abstract: We demonstrated great accuracy to CT scan biometry with 1-prism Mourits exophthalmometer, low accuracy with the Luedde instrument, and intermediate accuracy with the Hertel exophthalmometer, with fair intraobserver and interobserver reproducibility.

Cited by 16 publications

References 17 publications

Association of anthropometric markers with globe position: A population-based MRI study

Association of anthropometric markers with globe position: A population-based MRI study

The feasibility analysis of calculating proptosis by simple Pythagorean theorem

The feasibility analysis of calculating proptosis by simple Heron’s formula

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