Exophthalmometry with computed tomography

Gushchina, M B; Afanasyeva, D.S.; Борзенок, С.А.

doi:10.17116/oftalma2018134248-52

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…The Hertel exophthalmometer is not the only tool for measuring exophthalmos, but it is the only one so far practical to use in clinical practice . Magnetic resonance imaging and computed tomography scans have also been shown to measure eyeball protrusion accurately, and the results correlated well with the Hertel exophthalmometer .…”

Section: Discussionmentioning

confidence: 99%

Using Smartphone Exophthalmometry to Measure Eyeball Protrusion

Popov,

Fierz,

Bockisch

et al. 2023

JAMA Ophthalmol

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ImportanceThe current clinical criterion standard for measuring abnormal eyeball protrusion is still the historic Hertel exophthalmometer, which is prone to reading errors. Therefore, a smartphone application has been developed to measure exophthalmos.ObjectiveTo evaluate a relatively simple noninvasive measurement method for exophthalmos using a smartphone.Design, Setting, and ParticipantsThis cross-sectional study compared smartphone exophthalmometry with the existing reference standard, the Hertel exophthalmometer, or a professional high-resolution 3-dimensional scanner. Participants were patients with exophthalmos due to Graves orbitopathy and other intraorbital conditions and healthy volunteers who were recruited between June 2019 and January 2022 from the Department of Ophthalmology, University Hospital Zurich.InterventionsAll participants were examined twice by 3 different operators using 3 different methods (smartphone, high-resolution scanner, or Hertel exophthalmometer) at an interval of a minimum of 2 weeks or after exophthalmos-changing treatment.Main Outcome MeasuresAccuracy and precision, test-retest reliability, and interoperator reliability of eyeball protrusion measurements obtained with the smartphone compared to the Hertel exophthalmometer and the high-resolution face scanner.ResultsOf 39 participants, 23 patients (median [IQR] age, 54 [44-59] years; 15 [65%] female and 8 [35%] male) showed a mean difference in eyeball protrusion of 3.3 mm and 16 healthy volunteers (median [IQR] age, 32 [30-37] years; 11 [69%] female and 5 [31%] male) of 0.8 mm without any significant difference between the 3 methods. Accuracy and precision agreement between exophthalmos measures with the smartphone and the Hertel exophthalmometer showed an intraclass correlation coefficient (ICC) of 0.89 (95% CI, 0.80-0.94) and 0.93 (95% CI, 0.83-0.97) for the high-resolution scanner. Interoperator agreement was highest for the high-resolution scanner (ICC, 0.99 [95% CI, 0.98-0.99]), followed by the smartphone (ICC, 0.95 [95% CI, 0.92-0.97]) and the Hertel exophthalmometer (ICC, 0.91 [95% CI, 0.85-0.95]). Test retest reliability was similarly high for the smartphone (ICC, 0.93 [95% CI, 0.82-0.95]), the Hertel exophthalmometer (ICC, 0.92 [95% CI, 0.83-0.96]), and the high-resolution scanner (ICC, 0.95 [95% CI, 0.89-0.97]).Conclusions and RelevanceThe findings of this study demonstrate relatively high accuracy and precision, interoperator reliability, and test-retest reliability for smartphone exophthalmometry. These data support the use of a smartphone in place of a Hertel exophthalmometer for measuring exophthalmos in the future.

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Section: Discussionmentioning

confidence: 99%

Using Smartphone Exophthalmometry to Measure Eyeball Protrusion

Popov,

Fierz,

Bockisch

et al. 2023

JAMA Ophthalmol

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“…The radiological method is considered to be more repeatable and less affected by objective factors than HE method, and hence, is applied in many diseases with enophthalmos or exophthalmos (28)(29)(30). As for the radiation CT, the amount per measurement is generally ∼28 mgy, which does little harm to the human body.…”

Section: Discussionmentioning

confidence: 99%

A novel method of measuring proptosis with computed tomography

Sun

Yin

et al. 2023

Acta Radiol

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Background Computed tomography (CT) can avoid interference factors and has been imported into some software to measure proptosis clinically as the golden standard. Purpose To establish a new method for semi-automatically measuring the proptosis on CT and evaluate its accuracy and reproducibility. Material and Methods A total of 50 orbital CT images were collected of healthy individuals, 25 patients with Graves ophthalmopathy (GO), and 25 patients with orbital fracture (OF). A new image processing software, MedrawHDC, was developed to semi-automatically measure the proptosis (MedrawHDC method). The classic radiological (CR) method (measuring proptosis with the software called Mimics) and MedrawHDC method were applied in all three groups (measured by observer S). Hertel's exophthalmometer (HE) method was also applied in the GO group. Moreover, two other observers were asked to measure the proptosis using MedrawHDC, to evaluate its reproducibility. Results The MedrawHDC method was highly consistent with the CR method in measuring proptosis (normal group: intraclass correlation coefficient [ICC] = 0.989; GO group: ICC = 0.979; OF group: ICC = 0.979). In the GO group, the value of proptosis measured by two radiological methods were consistent with that measured by the HE method (CR method: ICC = 0.703; MedrawHDC method: ICC = 0.697). Bland–Altman plots showed similar results. The measurements obtained by three observers were highly reproducible (ICC = 0.995). Conclusion The newly established MedrawHDC method, with high accessibility, convenience, and repeatability, is reliable in assessing proptosis. It shows high potential for wide application, having clinical value for scientific evaluation of proptosis.

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Exophthalmometry with computed tomography

Cited by 2 publications

References 6 publications

Using Smartphone Exophthalmometry to Measure Eyeball Protrusion

Using Smartphone Exophthalmometry to Measure Eyeball Protrusion

A novel method of measuring proptosis with computed tomography

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