Valores normativos de exoftalmometría en individuos hispanos / Normative exophthalmometry values in Hispanic individuals

Propósito Se han establecido valores normativos de exoftalmometría en individuos caucásicos, asiáticos y negros. Aunque estudios anteriores han examinado las medidas perioculares en diferentes grupos raciales y étnicos, este estudio es el primero en establecer valores normativos de exoftalmometría en una población hispana de la ciudad de Nueva York. Métodos Este estudio de corte transversal fue aprobado por el IRB y cumple con HIPAA. Se incluyeron pacientes adultos hispanos. El grado de prominencia ocular (valor de exoftalmometría, VE) y la distancia interorbitaria (base de Hertel, DIO) se obtuvo mediante el uso del exoftalmómetro de Hertel. Las diferencias en VE entre sexos se evaluaron utilizando la prueba t para dos muestras. Se utilizó modelo de regresión lineal múltiple para determinar el efecto de la edad, el sexo y el índice de masa corporal (IMC) en el VE. Resultados De los 277 individuos hispanos incluidos, 189 (68,2%) fueron mujeres y la edad media fue de 63,0 años (DE=15,0). La media de la base de Hertel y del VE para todos los participantes fue de 92,0mm (DE=4,1) y 16,7mm (DE=2,4), respectivamente. Los valores medios de exoftalmometría de los hombres fueron significativamente más altos que los de las mujeres (17,6mm y 16,2mm, respectivamente, p≤0,001). Los VE más altos se asociaron positivamente con el sexo masculino (ß=−1,60, p<0,0001) y el IMC (ß=0,084, p=0,001), pero no con la edad. Conclusiones El VE en individuos hispanos es de 16,7mm, el cual es mayor que el reportado para la mayoría de los caucásicos y asiáticos, pero menor que el de los individuos negros. Un VE más alto se asocia significativamente con el sexo masculino y un mayor IMC. Este estudio es el primero en crear los valores normativos de exoftalmometría en una población hispana y que puede ser utilizado como herramienta de referencia para en el diagnóstico y control de enfermedades orbitarias (AU)

Purpose Normative exophthalmometry values have been established in Caucasians, Asians, and Black individuals. While prior studies have examined periocular measurements in different racial and ethnic groups, this study is the first to establish a set of normative exophthalmometry values in a Hispanic population in New York City. Methods This prospective, cross-sectional cohort study was IRB approved and HIPAA compliant. Adult patients self-identifying as Hispanic were included. The degree of ocular prominence (exophthalmometry value, EV) and the inter-orbital distance (Hertel's base, IOD) was obtained by Hertel exophthalmometry. Differences in EV between sexes were evaluated using two sample t-tests. Multivariable linear regression was utilized to determine the effect of age, sex, and body mass index (BMI) on EV. Results Of the 277 Hispanic individuals included, 189 (68.2%) were female and the mean age was 63.0 years (SD=15.0). The mean Hertel's base and mean EV for all participants was 92.0mm (SD=4.1) and 16.7mm (SD=2.4), respectively. Average exophthalmometry values for men were significantly higher than women's (17.6mm and 16.2mm, respectively, p≤0.001). Higher EVs were positively associated with male gender (ß=−1.60, p<0.0001) and BMI (ß=0.084, p=0.001), but not age. Conclusions The mean EV in Hispanic individuals is 16.7mm, higher than that reported for most Caucasians and Asians, but less than that of Black individuals. Higher EV is significantly associated with male sex and increased BMI. This study is the first to create a set of normative exophthalmometry values in a Hispanic population, which may serve as a valuable tool for clinicians to reference when diagnosing and monitoring orbital disease (AU)

Optic Nerve Tortuosity and Globe Proptosis in Normal and Glaucoma Subjects.

PRéCIS:: Eyes with glaucoma have tauter optic nerves compared with normal eyes, which may exert more force on the optic nerve head tissues during eye movements. PURPOSE: The purpose of this study was to assess the difference in optic nerve tortuosity during eye movements and globe proptosis between primary open angle glaucoma and normal subjects using orbital magnetic resonance imaging (MRI). METHODS: Ten Chinese subjects matched for ethnicity and refractive errors were recruited, including 5 normal controls and 5 patients with primary open angle glaucoma. All subjects underwent MRI to assess their optic nerves and globes for 3 eye positions: primary gaze, adduction, and abduction. Optic nerve tortuosity (optic nerve length divided by the distance between 2 ends) and globe proptosis (maximum distance between the cornea and interzygomatic line) were measured from MRI images. RESULTS: In adduction, the tortuosity of normal eyes was significantly larger than that of the glaucomatous eyes. Optic nerve tortuosity in adduction in the control and glaucoma groups were 1.004±0.003 (mean±SD) and 1.001±0.001, respectively (P=0.037). Globe proptosis (primary gaze) in glaucoma subjects (19.14±2.11 mm) was significantly higher than that in control subjects (15.32±2.79 mm; P=0.046). CONCLUSIONS: In this sample, subjects with glaucoma exhibited tauter optic nerves and more protruding eye globes compared with normal eyes. This may impact optic nerve head deformations in anatomically predisposed patients.

Normal standards of eye projection in Turkish children 6 to 17 years of age.

BACKGROUND: There are a few international and Turkish reports on children's eye projection references. METHODS: This is a cross-sectional study. Data were obtained from the second study of the Determination of Anthropometric Measurements of Turkish Children and Adolescents study group (DAMTCA II).The study population was 4,533 primary and secondary school students aged 6 to 18 years (2,512 girls, 2,021 boys). A Hertel exophthalmometer was used; age- and gender-specific means and standard deviations and percentiles were calculated for eye projection. RESULTS: The 3rd, 5th, 10th, 25th, 50th, 75th, 80th, 85th, 90th, 95th, and 97th percentiles of right and left eye projection, and the mean and standard deviation for each age and gender were calculated. In 6-year-old children, the smoothed eye projection of the 3rd-97th percentiles for the right and left eye in boys were detected as 11.2 mm-17.0 mm for right eye and 11.1 mm-17.0 mm for left eye. In 17-year-old male adolescents, the 3rd-97th percentiles were detected as 11.9 mm-19.5 mm for the right eye and 11.8 mm-19.2 mm for the left eye. The 3rd-97th percentiles in 6-year-old girls were detected as 11.1 mm-17.1 mm for the right eye and 10.9 mm-17.1 mm for the left eye. In 17-year-old girls, the 3rd-97th percentiles were detected as 11.7 mm-19.4 mm for the right eye and 11.8-19.2 mm for the left eye. CONCLUSIONS: Age- and gender-specific references for exophthalmos provide important information both for the clinical decision-making process, and screening in the diagnosis of abnormal or pathological conditions which result in exophthalmos.

Exophthalmometry values of Turkish adult population and the effect of age, sex, refractive status, and Hertel base values on Hertel readings.

PURPOSE: To establish normal exophthalmometry values in the adult Turkish population, and the impact of age, gender, interpupillary distance, Hertel base selection, and refractive status on globe position. METHODS: Exophthalmometry measurements and refractive status of 2477 subjects were conducted in one tertiary and five primary health care centers. Change of globe position by age, intersex differences in terms of globe position, correlations of Hertel base with exophthalmometry results, and interpupillary distance (IPD) were evaluated. Multiple linear regression analysis was performed to test determination effect of each variable on final Hertel reading. RESULTS: Median Hertel reading was 13 mm, and 95% of the population had an upper limit of 17 mm for both eyes. There was a negative correlation between spherical equivalent of refractive status and exophthalmometry results and a weak positive correlation between IPD and exophthalmometry result. Mean Hertel value was found to decrease significantly after the third decade. Hertel base value was found to have moderate linear correlation with Hertel results. A weak correlation was detected with Hertel base/IPD ratio with final Hertel results. Multiple linear regression analysis was performed and only 13% and 20% of change in Hertel values bilaterally were found to be determined by other variables (age, IPD, refractive status, and Hertel base value) for females and males. CONCLUSIONS: Normative dataset for exophthalmometry results of the Turkish population is established to be used in clinical practice and research. Only 13% to 20% of change in Hertel values was detected to be determined by age, IPD and Hertel base values.

Normal range of exophthalmos values on orbit computerized tomography in Koreans.

The value of parameters in Hertel's exophthalmometry was measured by using orbit computerized tomography (CT) in this study. We selected images that revealed the center of the lens, the largest eyeball contour and the optic canal on the axial view of orbit CT. Parameters of exophthalmometry on orbit CT were the distance between the lateral orbital rims of both eyes (A), the shortest distance from the corneal center to line A (B), the B/A ratio, the distance between the lateral orbital rim and the medial orbital rim (C), the length of the line passing through the lens center from the apex to line C (D) and the D/C ratio. To compare the center position of the eye, we measure the axial length (E) and the longest distance between the corneal apex and the posterior pole (F) which is parallel to line B. We also calculated B-F/2 and Hertel-F/2 in order to know if there is a difference between measurements of orbit CT and of Hertel's exophthalmometer. Subjects were classified into group 1 (aged 8-13 years old) and group 2 (aged 20 years old more). Sixteen subjects were enrolled in group 1 (32 eyes). In group 2, 100 subjects were male (200 eyes) and 35 were female (70 eyes). In group 1, the mean value was 89.94 mm for A, 13.49 mm for B, 35.13 mm for C, 10.64 mm for D, 24.40 mm for E, 24.20 mm for F, 0.15 for the B/A ratio and 0.30 for the D/C ratio. In group 2, the mean value was 100.93 mm for A, 15.03 mm for B, 38.78 mm for C, 12.03 mm for D, 24.62 mm for E, 24.33 mm for F, 0.15 for the B/A ratio and 0.31 for the D/C ratio. There was a statistically significant difference between the two groups for parameters A, B, C and D (p = 0.001), but no significant difference for the B/A (p = 0.239) and D/C ratios (p = 0.803). In the males and females of group 2, there was a statistically significant difference for the B/A ratio (p = 0.028). We suggest that the value of the D/C ratio (0.30-0.31) could be used as the index of protrusion. The normal values of exophthalmometry parameters measured by orbit CT could also be helpful to evaluate the exact protrusion in orbital diseases.

Normal values of eye position and head size in Chinese children from Hong Kong.

We measured the eye position and head dimensions of Chinese children in Hong Kong. Values for exophthalmos, interpupillary distance (IPD), interorbital distance (IOD), distance between medial canthi, and head dimensions were found to be larger than those for Caucasian, Black, or other Chinese groups.

Eye position and head size in the Chinese population: a comparison of the Chinese from Hong Kong with the Chinese from Guangdong Province.

Measurements obtained in this study include facial and head dimensions. From our findings, it would appear that the Chinese population in Hong Kong have not become different in the two or three generations that separate them from those living in Guangdong province of China.

Normative data for hertel exophthalmometry in a normal adult black population.

Ocular protrusion data were obtained on 309 black adults using a Hertel exophthalmometer. The mean protrusion value for black men and women was 18.20 and 17.46 mm, respectively. The upper limit of normal was 24.14 and 22.74 mm for males and females, respectively. The differences between base measurement and mean protrusion values of black men and women were significantly different (p less than 0.015). These data are compared with those of adult white subjects and show that blacks have a higher range of normal than whites. The data indicate that the published upper limit of normal (21 mm) for exophthalmos is not appropriate for adult black patients.

Normal values of eye position in the Chinese population of Hong Kong.

Exophthalmos, interpupillary distance (IPD), interobital distance (IOD), and inner intercanthal distance (ICD) were measured in an adult Chinese population from Hong Kong (HKC). Mean values and normal range for 95% of the population were determined and the relation with head size and body height examined. Values of exophthalmos and IPD in our Chinese population were similar to those given for Caucasian groups. IOD and ICD were larger in the Chinese than in adult Caucasians. Our findings show generally larger values in the HKC than has been found for other populations in mainland China.