Interinstrument Variability in Hertel-Type Exophthalmometers

Sleep, Tamsin; Manners, R M

doi:10.1097/00002341-200207000-00004

Cited by 48 publications

(31 citation statements)

References 4 publications

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“…To reduce inter and intra observer variability, all subjects were examined by the same clinician at every visit and were repeatedly assessed using the single exophthalmometry. 14 We used the median value of exophthalmometry among repeated measurements. Clinical activity of the disease was assessed using a clinical activity score (CAS) based upon seven signs of orbit inflammation.…”

Section: Methodsmentioning

confidence: 99%

Clinical features of thyroid-associated ophthalmopathy in clinically euthyroid Korean patients

Jang

Lee

et al. 2012

Eye

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Aim To compare clinical characteristics and thyroid-stimulating hormone receptor antibodies (TRAbs) in thyroid-associated ophthalmopathy (TAO) in euthyroid Korean patients with those in hyperthyroid patients. Methods Clinical activity scores (CASs), modified NOSPECS scores, exophthalmometry values, prevalence of optic neuropathy, restrictive myopathy and lid retraction, and the positivity and levels of TRAb (thyrotropin-binding inhibitor immunoglobulin (TBII) and thyroidstimulating immunoglobulin (TSI)) were compared in 24 euthyroid (group A) and 139 clinical/subclinical hyperthyroid TAO patients (group B). Results Group A presented more clinically unilateral involvement than group B (79.2% vs 27.3%, Po0.001), less active (CAS 1.50 vs 2.26, P ¼ 0.014) and less severe clinical course (NOSPECS 3.38 vs 4.13, P ¼ 0.037). Lid retraction was more prevalent in group A than group B (91.7% vs 66.2%, P ¼ 0.014). Prevalence of optic neuropathy and restrictive myopathy, and the mean value of exophthalmometry were not different. Mean TBII levels were lower (7.20 IU/l) in group A than in group B (44.58 IU/l, Po0.001). A similar difference was found in the TSI bioassay (201.40% vs 425.19%, P ¼ 0.001). The positive rate of TBII in group A (34.8%) was significantly lower than in group B (90.8%, Po0.001). The positive rate of TSI was high in both group A (83.3%) and B (91.7%), with no significant difference (P ¼ 0.337).Conclusions Patients with euthyroid TAO showed a less active and severe clinical course, more unilateral involvement, and lower levels of TRAb than those in patients with hyperthyroid TAO. These distinct clinical and biochemical characteristics might be useful in assessment of euthyroid TAO, and the TSI might be more sensitive for diagnosing these patients.

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Section: Methodsmentioning

confidence: 99%

Clinical features of thyroid-associated ophthalmopathy in clinically euthyroid Korean patients

Jang

Lee

et al. 2012

Eye

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“…Of these, the Hertel exophthalmometer is still the most widely used instrument for measuring exophthalmos; although several limitations have been identified in its use. [7][8][9] Protrusion of eyeball, difference of both eyes' protrusion (asymmetry), and the distance between lateral orbital rims (base) were recorded. The study was as proved by the institutional review board.…”

Section: Between January 2002 and May 2004 163mentioning

confidence: 99%

Exophthalmos of patients with Graves' disease in Chinese of Taiwan

Tsai

Kau²,

Kao

et al. 2005

Eye

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Purpose To determine the exophthalmos measurements in patients with Graves' disease (GD) and to compare with those of normal subjects among the Chinese of Taiwan. Methods Hertel's exophthalmometry were performed in 163 consecutive adult GD patients and 419 normal subjects. The values of exophthalmos, asymmetry, and the distance between lateral orbital rims (base) were evaluated. Results There was a significant difference between GD and normal adults for exophthalmos and asymmetry, with GD patients demonstrating a mean exophthalmos of 18.32 mm and asymmetry of 0.93 mm as compared with 13.91 and 0.55 mm for normal subjects (Po0.001). The mean value of base for GD adults (106.52 mm) is slightly greater than normal subjects (105.82 mm). There was no gender difference in exophthalmometric value or asymmetry in each group. A total of 79 (48.5%) GD patients had exophthalmos greater than the upper limit of normal Chinese in Taiwan (18.6 mm). Asymmetry over 2 mm was observed in 11 (6.7%) patients with GD but in none of the normal subjects. Conclusions GD patients have significant exophthalmos and asymmetry compared to normal subjects. In comparison with previous studies, exophthalmos values for Chinese in Taiwan tend to be lower than those of Caucasians and black-American people, but are close to those of Korean, Japanese, Iranian, Indian, and Asian-American people. Adequate adjustment of normal and abnormal values of exophthalmos according to individual differences is important for the diagnosis of orbital morbidity and management of thyroid associated orbitopathy.

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“…Há mais de 40 tipos de exoftalmômetros descritos na literatura desde 1865 (9) . Dentre eles, os exoftalmômetros de Lued, Mutch e Hertel avaliam a protrusão ocular através da margem orbitária lateral (4) .…”

Section: Discussionunclassified

“…No entanto, as médias da exoftalmometria no adulto normal com o exoftalmômetro de Hertel, realizadas em vários países, apresentam variações (9,10) . Evidências antropológicas mostram que a estrutura esquelética pode diferir entre as raças e também entre os sexos (4) .…”

Section: Introductionunclassified

Valores da exoftalmometria média na população adulta da região do Grande ABC, São Paulo/Brasil

Moysés

Lucci

Júnior

et al. 2010

Rev. bras.oftalmol.

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RESUMOObjetivo: Estabelecer padrões de normalidade dos valores da exoftalmometria de ambos os olhos e da distância entre os rebordos orbitários laterais (base) em adultos jovens da população do Grande ABC São Paulo/Brasil. Métodos: Realizou-se a exoftalmometria com o exoftalmômetro de Hertel, em 129 pacientes do sexo feminino e 75 do sexo masculino, na faixa etária de 25 a 55 anos. Os pacientes foram separados em três grupos raciais (brancos, negros e pardos). Resultados: A variação da exoftalmometria encontrada na população em estudo foi de 10 a 23mm, média de 15,57 ±2,43mm. No sexo feminino a média foi de 15,42 ±2,40mm e no masculino, 15,83 ±2,47mm. Não se encontrou uma relação estatisticamente significativa entre os sexos feminino e masculino (p=0,25). Na raça branca a média foi de 15,57 ±2,46mm, na negra foi de 16,20 ±2,70mm e na parda foi de 15,02 ±2,01mm. A diferença foi estatisticamente significativa (p=0,008) entre as raças negra e parda. A medida da base variou de 104 a 125mm (média de 113,91 ±4,37mm). A diferença entre homens e mulheres foi estatisticamente significativa (p<0,001). Na raça branca a média da base encontrada foi de 112,18 ±4,02mm, na negra foi de 115,37 ±4,71mm e na parda, 115,18 ±3,66mm. A diferença da média da base foi estatisticamente significativa (p<0,001) entre as raças branca e negra e branca e parda. Nenhum paciente apresentou assimetria entre os dois olhos maior que 2mm. Conclusão: O padrão de normalidade da exoftalmometria encontrado para a população em estudo foi de 10 a 23mm e a base variou de 104 a 125mm.

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Interinstrument Variability in Hertel-Type Exophthalmometers

Cited by 48 publications

References 4 publications

Clinical features of thyroid-associated ophthalmopathy in clinically euthyroid Korean patients

Clinical features of thyroid-associated ophthalmopathy in clinically euthyroid Korean patients

Exophthalmos of patients with Graves' disease in Chinese of Taiwan

Valores da exoftalmometria média na população adulta da região do Grande ABC, São Paulo/Brasil

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