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Multiple radial midpupil lid distances: a simple method for lid contour analysis
Gherusa H Milbratz1, Denny M Garcia, Fernando C Guimarães
1School of Medicine of Ribeirão Preto, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo, Brazil.
Ophthalmology
|December 27, 2011
Summary
A new computerized method analyzes lid contour using radial midpupil lid distances (MPLD). This technique effectively identifies upper eyelid retraction in Graves' disease patients, showing maximum asymmetry at 60° from the midline.
Area of Science:
- Ophthalmology
- Medical Imaging
- Diagnostic Technology Evaluation
Background:
- Graves' disease commonly causes upper eyelid retraction, altering normal lid contour.
- Accurate measurement of lid contour is crucial for diagnosis and management.
- Existing methods may not fully capture the complex changes in lid shape.
Purpose of the Study:
- To introduce and validate a novel computerized method for analyzing eyelid contour.
- To quantify lid contour abnormalities using multiple radial midpupil lid distances (MPLD).
- To assess the utility of this method in identifying Graves' upper eyelid retraction.
Main Methods:
- Evaluation of diagnostic technology using monocular palpebral fissure images.
- Analysis of images from 35 Graves' patients and 30 controls.
- Custom software measured conventional and 12 oblique midpupil lid distances (MPLDs) across lid fissure sectors.
Main Results:
- Midpupil lid distances increased from the midline in both nasal and temporal sectors.
- Graves' patients showed significantly different MPLDs at all angles compared to controls (P<0.0001).
- The greatest temporal/nasal asymmetry in Graves' patients occurred 60° from the vertical midline.
Conclusions:
- Radial MPLD measurement is a simple, effective method for characterizing lid contour abnormalities.
- The computerized method accurately differentiates Graves' upper eyelid retraction from normal.
- Maximum lateral lid flare in Graves' disease was localized to 60° from the vertical midline.
