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Comparative study of 3 exophthalmometers and computed tomographic biometry.

Juliette Delmas¹, Jean-Marie Loustau², Sylvain Martin³

¹1 Department of Ophthalmology, Limoges Hospital, Limoges - France.

European Journal of Ophthalmology

|November 8, 2017

Summary

The Mourits exophthalmometer demonstrated high accuracy and reproducibility for measuring eye protrusion, outperforming the Luedde and Hertel instruments. This finding is crucial for diagnosing and monitoring orbital conditions like Graves disease.

Keywords:

Biometry Computed tomography scan Exophthalmometer Hertel

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Area of Science:

Ophthalmology
Medical Imaging
Biometry

Background:

Accurate exophthalmometry is essential for diagnosing and managing orbital diseases, particularly Graves disease.
Existing commercial exophthalmometers show considerable variation in their measurements.

Purpose of the Study:

To compare the accuracy and reproducibility of three exophthalmometers (Luedde, Hertel, Mourits) against cerebral computed tomography (CT) scan biometry.
To evaluate intraobserver and interobserver reliability for each instrument.

Main Methods:

Sixty patients undergoing cerebral CT scans were included in the study.
External prebicanthal segments (EPBCS), interorbital distance, and globe axial length were measured.
Measurements from Luedde, Hertel, and Mourits exophthalmometers were compared to CT scan data.
Intraclass correlation coefficient (ICC) and Bland and Altman plots assessed reproducibility.

Main Results:

The Mourits exophthalmometer showed very good to good concordance with CT biometry.
The Hertel exophthalmometer demonstrated moderate to good concordance.
The Luedde ruler exhibited only moderate concordance with CT scan biometry.
High intraobserver and interobserver reproducibility were noted, particularly for the Mourits exophthalmometer.

Conclusions:

The 1-prism Mourits exophthalmometer offers superior accuracy compared to CT scan biometry.
The Luedde and Hertel exophthalmometers provide lower and intermediate accuracy, respectively.
The Mourits exophthalmometer is recommended for accurate exophthalmos measurement in clinical practice.