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A Comparative Study of Clinical vs. Digital Exophthalmometry Measurement Methods
Tháıs de Sous Pereira1, Cristina Hiromi Kuniyoshi2, Cristiane de Almeida Leite1
1Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil.
Clinical Hertel exophthalmometry is more accurate than digital photography for measuring exophthalmos. While digital methods show correlation, Hertel exophthalmometry offers better agreement with CT scans for orbital disease evaluation.
Area of Science:
- Ophthalmology
- Medical Imaging
Background:
- Accurate measurement of exophthalmos is crucial for evaluating orbital diseases.
- No universally accepted gold standard exists for exophthalmos measurement.
Purpose of the Study:
- To compare the reproducibility, correlation, and agreement of digital photography and clinical Hertel exophthalmometry (HE) with Computerized Tomography (CT) measurements.
- To determine the most accurate method for exophthalmos assessment.
Main Methods:
- Seventeen patients with proptosis and 15 with normal orbits underwent orbital CT, HE, and digital facial photographs.
- Measurements were taken twice by the same examiner and once by another.
- Statistical analysis included Pearson correlation coefficient (PCC) and Bland-Altman plots.
Main Results:
- Digital exophthalmometry measurements were significantly greater than HE measurements.
- Hertel exophthalmometry (HE) demonstrated stronger correlation and better agreement with CT scan measurements compared to digital photography.
- Inter-/intraclass correlation coefficients indicated high reliability for HE and CT, and moderate reliability for digital methods.
Conclusions:
- Hertel exophthalmometry (HE) remains a more accurate and reliable method for exophthalmos measurement than digital photography.
- Digital exophthalmometry, despite showing correlation, is not as accurate as clinical HE when compared to CT scans.
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