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Smadar L, Arazi M, Greenberg G, Haviv L, Benifla O, Zabatani A, Fabian I, Dagan M, Gutovitz JM, Ben Simon GJ, Landau-Prat D. Semiautomated MRI-Based Method for Orbital Volume and Contour Analysis. Ophthalmic Plast Reconstr Surg 2024:00002341-990000000-00370. [PMID: 38534059 DOI: 10.1097/iop.0000000000002656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
OBJECTIVE The architecture of the orbital cavity is intricate, and precise measurement of its growth is essential for managing ocular and orbital pathologies. Most methods for those measurements are by CT imaging, although MRI for soft tissue assessment is indicated in many cases, specifically pediatric patients. This study introduces a novel semiautomated MRI-based approach for depicting orbital shape and dimensions. DESIGN A retrospective cohort study. PARTICIPANTS Patients with at least 1 normal orbit who underwent both CT and MRI imaging at a single center from 2015 to 2023. METHODS Orbital dimensions included volume, horizontal and vertical lengths, and depth. These were determined by manual segmentation followed by 3-dimensional image processing software. MAIN OUTCOME MEASURES Differences in orbital measurements between MRI and CT scans. RESULTS Thirty-one patients (mean age 47.7 ± 23.8 years, 21 [67.7%]) females, were included. The mean differences in delta values between orbital measurements on CT versus MRI were: volume 0.03 ± 2.01 ml, horizontal length 0.53 ± 2.12 mm, vertical length, 0.36 ± 2.53 mm, and depth 0.97 ± 3.90 mm. The CT and. MRI orbital measurements were strongly correlated: volume (r = 0.92, p < 0.001), horizontal length (r = 0.65, p < 0.001), vertical length (r = 0.57, p = 0.001), and depth (r = 0.46, p = 0.009). The mean values of all measurements were similar on the paired-samples t test: p = 0.9 for volume (30.86 ± 5.04 ml on CT and 30.88 ± 4.92 ml on MRI), p = 0.2 for horizontal length, p = 0.4 for vertical length, and p = 0.2 for depth. CONCLUSIONS We present an innovative semiautomated method capable of calculating orbital volume and demonstrating orbital contour by MRI validated against the gold standard CT-based measurements. This method can serve as a valuable tool for evaluating diverse orbital processes.
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Affiliation(s)
- Lital Smadar
- Orbital Ophthalmic Plastic & Lacrimal Surgery Institute, Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv
| | - Mattan Arazi
- Orbital Ophthalmic Plastic & Lacrimal Surgery Institute, Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv
| | - Gahl Greenberg
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv
- Department of Diagnostic Imaging, Section of Neuroradiology, Sheba Medical Center, Ramat Gan
| | - Limor Haviv
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv
- PlanNet - The Sheba 3D Lab, Sheba Medical Center
| | - Or Benifla
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv
- PlanNet - The Sheba 3D Lab, Sheba Medical Center
| | - Amit Zabatani
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv
- Department of Orthopedics, Sheba Medical Center
- The Sheba Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer
| | - Ina Fabian
- Department of Cell and Developmental Biology, School of Medicine, Tel Aviv University, Tel Aviv
| | - Mayan Dagan
- Adelson school of medicine, Ariel University, Ariel, Israel
| | - Joel M Gutovitz
- Orbital Ophthalmic Plastic & Lacrimal Surgery Institute, Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv
| | - Guy J Ben Simon
- Orbital Ophthalmic Plastic & Lacrimal Surgery Institute, Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv
- The Sheba Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer
| | - Daphna Landau-Prat
- Orbital Ophthalmic Plastic & Lacrimal Surgery Institute, Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv
- The Sheba Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer
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Watke MA. Prediction of exophthalmos by body mass index for craniofacial reconstruction: consequences for cold cases. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00649-8. [PMID: 37280468 DOI: 10.1007/s12024-023-00649-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 06/08/2023]
Abstract
It is inconvenient for a forensic practitioner to gather population-specific data before performing a facial reconstruction. The inconvenience may defeat the point of creating the reconstruction. The objective of this study was to evaluate a non-population-dependent method of determining exophthalmos. The protrusion of the eyeball is known to vary with the contents of the orbital cavity based on bony orbital resorption or increased or decreased fat contents, as well as according to relative eyeball size. Of use are available statistics on body mass index, and this is discussed within the context of eyeball protrusion. A weak positive correlation (0.3263) between the body mass index of the country where the study originated, and the degree of exophthalmos was found. The results suggest that eyeball protrusion rates can be established according to body mass index, and this framework may be more useful considering conventional police practices.
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Tsiogka A, Petrou P, Droutsas K, Nikolopoulou A, Papaconstantinou D, Chatzistefanou KI. Hertel Exophthalmometry Values in a Greek Adult Outpatient Clinic-Based Population: Association With Demographic Factors and Systemic Disease. Cureus 2023; 15:e35027. [PMID: 36938254 PMCID: PMC10023137 DOI: 10.7759/cureus.35027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 02/17/2023] Open
Abstract
PURPOSE To investigate correlations of exophthalmometry values (EVs) with age, gender, and the presence of diabetes mellitus, arterial hypertension, and dyslipidemia. METHODS In a cross-sectional, clinic-based study, consecutive adult Greek patients presenting for evaluation at the outpatient general clinic on a scheduled appointment basis at a tertiary care referral center were submitted to Hertel exophthalmometry in both eyes by the same observer. Subjects with signs of history or orbital pathology, including thyroid-associated ophthalmopathy, were excluded. Demographics, as well as a detailed systemic history report, were recorded. Mixed effect linear regression analysis was performed to account for the correlation between the eyes of the same participant. RESULTS A total of 800 eyes (400 subjects) were included, 194 males and 206 females, with a mean age of 67.82 ± 12 years (range: 18-92 years). The mean exophthalmometry value was 15.7 ± 2.6 mm (range: 11-21 mm). Every one year of increase in age is associated with a decrease in EVs by 0.03 mm (95% CI -0.04, -0.02/p-value<0.001). Female gender was associated with lower EVs by 0.33mm (95% CI-0.56, -0.1/p-value=0.005). Patients with diabetes mellitus had higher EVs by 0.47 mm (95% CI 0.25, 0.70/p-value<0.001) compared to patients without diabetes, and patients with arterial hypertension had lower EVs by 0.26 mm (95% CI -0.5, -0.02/p-value=0.034) compared to patients without hypertension. No association was found between dyslipidemia and systemic history of thyroid dysfunction. Conclusions: A negative correlation of EVs was noted with increasing age, female gender, as well as history of arterial hypertension and a positive correlation with diabetes mellitus.
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Affiliation(s)
| | - Petros Petrou
- Ophthalmology, General Hospital of Athens "G. Gennimatas", Athens, GRC
| | | | - Anthi Nikolopoulou
- Strabismus Service, General Hospital of Athens "G. Gennimatas", Athens, GRC
| | | | - Klio I Chatzistefanou
- Ophthalmology, Strabismus Service, General Hospital of Athens "G. Gennimatas", Athens, GRC
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4
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Gamulescu MA. [Gender medicine in ophthalmology : The "small difference" between women and men]. Ophthalmologe 2020; 117:831-842. [PMID: 32699941 DOI: 10.1007/s00347-020-01174-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Gender-specific or sex-specific medicine is part of "personalized" medicine. After differences in heart diseases between women and men were first identified and increasingly published in the field of cardiology since the 1980s, differences between the sexes have also become the focus of interest in other disciplines. Immunological and hormonal aspects indicate significant differences, e.g. in the severity of the disease or the response to treatment. Even in ophthalmology epidemiological differences in some diseases are known but so far these do not lead to a different approach in the practical treatment of patients. This CME article aims to raise awareness of gender medicine also in the field of ophthalmology and at the same time to promote understanding of these differences by presenting the fundamental differences between the sexes.
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Affiliation(s)
- M-A Gamulescu
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Deutschland.
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Park S, Park DY, Kim J, Woo KI, Kim YD, Han J, Chung TY, Cha HS, Lim DH. Enhanced orbital adipogenesis in a mouse model of T-cell-mediated autoimmunity, zymosan A-treated SKG mice: Implications for Graves' ophthalmopathy. Sci Rep 2020; 10:7329. [PMID: 32355208 PMCID: PMC7193596 DOI: 10.1038/s41598-020-64402-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 04/14/2020] [Indexed: 01/07/2023] Open
Abstract
Inflammation and remodelling of orbital tissue associated with enhanced adipogenesis commonly occur in Graves' ophthalmopathy (GO), however, the underlying mechanisms that link immune cells and adipocytes in orbital inflammation are not well-known. The primary aim of this study was to elucidate how a genetically determined shift in the T-cell repertoire toward self-reactive T-cells could drive orbital adipogenesis. To induce the T-cell-mediated autoimmune response, SKG mice were intraperitoneally injected with zymosan A once at 8 weeks of age. After three months, orbital magnetic resonance imaging (MRI), histopathologic studies, and in vitro analyses were performed to evaluate inflammation and adipogenesis. The eyes of the zymosan A-treated SKG mice displayed proptosis and blepharitis. A detailed analysis of orbital adipose tissue showed enhanced orbital adipogenesis and cellular infiltration compared to controls. In addition, increased secretion of adipokines and other cytokines in the periorbital tissue was observed, together with elevated serum concentration of inflammatory cytokines. Orbital adipogenesis was enhanced in zymosan A-treated SKG mice, a novel mouse model for GO-like inflammatory adipose phenotypes most likely induced by T-cell mediated autoimmune responses. This mouse model gives us the opportunity to examine the underlying molecular mechanisms of enhanced adipogenesis in GO, ultimately providing a potential therapeutic target alternative to conventional GO treatment.
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Affiliation(s)
- Sera Park
- Samsung Biomedical Research Institute, Seoul, Republic of Korea
| | - Dae-Young Park
- Department of Ophthalmology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jaeryung Kim
- Department of Ophthalmology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyung In Woo
- Department of Ophthalmology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yoon-Duck Kim
- Department of Ophthalmology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jisang Han
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tae-Young Chung
- Department of Ophthalmology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hoon-Suk Cha
- Division of Rheumatology, Department of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Dong Hui Lim
- Department of Ophthalmology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Bontzos G, Mazonakis M, Papadaki E, Maris TG, Blazaki S, Drakonaki EE, Detorakis ET. Orbital volume measurements from magnetic resonance images using the techniques of manual planimetry and stereology. Natl J Maxillofac Surg 2020; 11:20-27. [PMID: 33041572 PMCID: PMC7518488 DOI: 10.4103/njms.njms_9_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/08/2020] [Accepted: 05/15/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction: Current volume measurement techniques, for the orbit, are time-consuming and involve complex assessments, which prevents their routine clinical use. In this study, we evaluate the applicability and efficacy of stereology and planimetry in orbital volume measurements using magnetic resonance imaging (MRI). Materials and Methods: Prospective imaging study using MRI. Sheep craniums and human subjects were evaluated. Water-filling measurements were performed in animal skulls, as the standard validation technique. Planimetry and stereology techniques were used in each dataset. Intraobserver and interobserver reliability testing were applied. Results: In stereology customization, 1/6 systematic sampling scheme was determined as optimal with acceptable coefficient of error (3.09%) and low measurement time (1.2 min). In sheep craniums, the mean volume measured by water displacement, planimetry, and stereology was 17.81 ± 0.59 cm3, 18.53 ± 0.24 cm3, and 19.19 ± 0.17 cm3, respectively. Planimetric and stereological methods were highly correlated (r = 0.94; P ≈ 0.001). The mean difference of the orbital volume using planimetry and stereology was 0.316 ± 0.168 cm3. In human subjects, using stereology, the mean orbital volume was found to be 19.62 ± 0.2 cm3 with a CE of 3.91 ± 0.15%. Conclusions: The optimized stereological method was found superior to manual planimetry in terms of user effort and time spent. Stereology sampling of 1/6 was successfully applied in human subjects and showed strong correlation with manual planimetry. However, optimized stereological method tended to overestimate the orbital volume by about 1 cc, a considerable limitation to be taken in clinical practice.
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Affiliation(s)
- Georgios Bontzos
- Department of Ophthalmology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Michael Mazonakis
- Department of Medical Physics, University of Crete, Heraklion, Greece
| | - Efrosini Papadaki
- Department of Radiology, University Hospital of Heraklion, Heraklion, Greece
| | - Thomas G Maris
- Department of Medical Physics, University of Crete, Heraklion, Greece
| | - Styliani Blazaki
- Department of Ophthalmology, University Hospital of Heraklion, Heraklion, Crete, Greece
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Schmidt P, Kempin R, Langner S, Beule A, Kindler S, Koppe T, Völzke H, Ittermann T, Jürgens C, Tost F. Association of anthropometric markers with globe position: A population-based MRI study. PLoS One 2019; 14:e0211817. [PMID: 30730926 PMCID: PMC6366780 DOI: 10.1371/journal.pone.0211817] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 01/20/2019] [Indexed: 12/19/2022] Open
Abstract
Purpose Exophthalmometry is a common examination in ophthalmology. For example it is relevant for diagnosis or follow-up of thyroid eye disease. However, exophthalmometry is affected by several factors such as ethnicity, sex and age. The purpose of this study was to determine the globe position by magnetic resonance imaging (MRI) and to investigate its correlates among the general Northeast German adult population. Methods A total of 3030 subjects aged between 20 and 89 from the population-based Study of Health in Pomerania (SHIP) underwent a standardised whole-body MRI. Axial length and globe position were determined in axial T1-weighted images of the orbit. The image had to include the corneal apex as well as the optic nerve head. Study participants were excluded from imaging analysis if there was no plane available that included both structures. Further exclusion criterion was a lateral deviation of the subject’s viewing direction. Images with inadequate quality due to motion artefacts or other technical reasons were excluded as well. Globe position was defined as the perpendicular distance between the interzygomatic line and the posterior surface of the cornea (exophthalmometric value). The distance between the posterior surface of the cornea and the posterior pole of the eyeball, at the boundary with orbital fat, was defined as axial length. We used posterior surface of the cornea for our measurements, because it seemed to be less vulnerable for motion artefacts than the anterior one. Moreover body measurements including body mass index (BMI), waist and hip circumferences were determined. Associations between anthropometric measurements with exophthalmometric outcomes were analysed by linear regressions adjusted for age and stratified by sex. P-values <0.05 were considered as statistically significant. To assess intra-reader variability intra-class correlation coefficients (ICC) were computed for repeated measurements of the MRI scans of 25 subjects. Results After considering the exclusion criteria 1926 evaluable subjects remained. There was no significant difference between means of right and left eyes. The mean exophthalmometric value was significantly higher in men (16.5 +/- 2.2 mm) than in women (15.3 +/- 2.1 mm). The mean MRI-axial length was 23.4 +/- 0.8 mm for men and 22.8 +/- 0.9 mm for women. BMI, waist and hip circumferences were positively correlated with exophthalmometric value (p<0.001). Difference of mean MRI-based exophthalmometric value for obese subjects (BMI ≥30 kg/m2) and non-overweight (BMI <25 kg/m2) was 2.1 mm for men and 1.6 mm for women. ICC between 0.97 and 0.99 indicate excellent repeatability of our method. Conclusion We conclude that MRI-based exophthalmometric values are positively correlated with BMI, waist- and hip-circumference among the general Northeast German adult population. This association is independent from age and axial length. Consequently bodyweight of patients should be regarded to interpret exophthalmometric values correctly. MRI-exophthalmometry seems to be a suitable method to determine globe position. Considering the large number of study participants, exophthalmometric values of our study could be used as comparative values for exophthalmometry of people of Western European descent in future.
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Affiliation(s)
- Patrick Schmidt
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
| | - Robert Kempin
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
| | - Sönke Langner
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Rostock, Rostock, Mecklenburg-Western Pomerania, Germany
| | - Achim Beule
- Department of Otorhinolaryngology, University Clinic Münster, Münster, North Rhine Westphalia, Germany
| | - Stefan Kindler
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
| | - Thomas Koppe
- Department of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
| | - Clemens Jürgens
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
| | - Frank Tost
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
- * E-mail:
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8
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Pereira‐Pedro AS, Masters M, Bruner E. Shape analysis of spatial relationships between orbito-ocular and endocranial structures in modern humans and fossil hominids. J Anat 2017; 231:947-960. [PMID: 29027198 PMCID: PMC5696126 DOI: 10.1111/joa.12693] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2017] [Indexed: 11/30/2022] Open
Abstract
The orbits and eyes of modern humans are situated directly below the frontal lobes and anterior to the temporal lobes. Contiguity between these orbital and cerebral elements could generate spatial constraints, and potentially lead to deformation of the eye and reduced visual acuity during development. In this shape analysis we evaluate whether and to what extent covariation exists between ocular morphology and the size and spatial position of the frontal and temporal areas in adult modern humans. Magnetic resonance imaging (MRI) was used to investigate patterns of variation among the brain and eyes, while computed tomography (CT) was used to compare cranial morphology in this anatomical region among modern humans, extinct hominids and chimpanzees. Seventeen landmarks and semi-landmarks that capture the outline of the eye, frontal lobe, anterior fossa/orbital roof and the position of the temporal tips were sampled using lateral scout views in two dimensions, after projection of the average grayscale values of each hemisphere, with midsagittal and parasagittal elements overlapped onto the same plane. MRI results demonstrated that eye position in adult humans varies most with regard to its horizontal distance from the temporal lobes and, secondly, in its vertical distance from the frontal lobes. Size was mainly found to covary with the distance between the eye and temporal lobes. Proximity to these cerebral lobes may generate spatial constraints, as some ocular deformation was observed. Considering the CT analysis, modern humans vary most with regard to the orientation of the orbits, while interspecific variation is mainly associated with separation between the orbits and endocranial elements. These findings suggest that size and position of the frontal and temporal lobes can affect eye and orbit morphology, though potential effects on eye shape require further study. In particular, possible effects of these spatial and allometric relationships on the eye and vision should be examined using ontogenetic samples, vision parameters such as refractive error in diopters, and three-dimensional approaches that include measures of extraocular soft tissues within the orbit.
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Affiliation(s)
| | | | - Emiliano Bruner
- Centro Nacional de Investigación sobre la Evolución HumanaBurgosSpain
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9
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A Novel Three-Dimensional Vector Analysis of Axial Globe Position in Thyroid Eye Disease. J Ophthalmol 2017; 2017:7253898. [PMID: 28491471 PMCID: PMC5401755 DOI: 10.1155/2017/7253898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 02/19/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose. To define a three-dimensional (3D) vector method to describe the axial globe position in thyroid eye disease (TED). Methods. CT data from 59 patients with TED were collected and 3D images were reconstructed. A reference coordinate system was established, and the coordinates of the corneal apex and the eyeball center were calculated to obtain the globe vector EC→. The measurement reliability was evaluated. The parameters of EC→ were analyzed and compared with the results of two-dimensional (2D) CT measurement, Hertel exophthalmometry, and strabismus tests. Results. The reliability of EC→ measurement was excellent. The difference between EC→ and 2D CT measurement was significant (p = 0.003), and EC→ was more consistent with Hertel exophthalmometry than with 2D CT measurement (p < 0.001). There was no significant difference between EC→ and Hirschberg test, and a strong correlation was found between EC→ and synoptophore test. When one eye had a larger deviation angle than its fellow, its corneal apex shifted in the corresponding direction, but the shift of the eyeball center was not significant. The parameters of EC→ were almost perfectly consistent with the geometrical equation. Conclusions. The establishment of a 3D globe vector is feasible and reliable, and it could provide more information in the axial globe position.
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11
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Bingham CM, Sivak-Callcott JA, Gurka MJ, Nguyen J, Hogg JP, Feldon SE, Fay A, Seah LL, Strianese D, Durairaj VD, Uddin J, Devoto MH, Harris M, Saunders J, Osaki TH, Looi A, Teo L, Davies BW, Elefante A, Shen S, Realini T, Fischer W, Kazim M. Axial Globe Position Measurement: A Prospective Multicenter Study by the International Thyroid Eye Disease Society. Ophthalmic Plast Reconstr Surg 2016; 32:106-12. [PMID: 25719380 PMCID: PMC4549213 DOI: 10.1097/iop.0000000000000437] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE Identify a reproducible measure of axial globe position (AGP) for multicenter studies on patients with thyroid eye disease (TED). METHODS This is a prospective, international, multicenter, observational study in which 3 types of AGP evaluation were examined: radiologic, clinical, and photographic. In this study, CT was the modality to which all other methods were compared. CT AGP was measured from an orthogonal line between the anterior lateral orbital rims to the cornea. All CT measurements were made at a single institution by 3 individual clinicians. Clinical evaluation was performed with exophthalmometry. Three clinicians from each clinical site assessed AGP with 3 different exophthalmometers and horizontal palpebral width using a ruler. Each physician made 3 separate measurements with each type of exophthalmometer not in succession. All photographic measurements were made at a single institution. AGP was measured from lateral photographs in which a standard marker was placed at the anterior lateral orbital rim. Horizontal and vertical palpebral fissure were measured from frontal photographs. Three trained readers measured 3 separate times not in succession. Exophthalmometry and photography method validity was assessed by agreement with CT (mean differences calculation, intraclass correlation coefficients [ICCs], Bland-Altman figures). Correlation between palpebral fissure and CT AGP was assessed with Pearson correlation. Intraclinician and interclinician reliability was evaluated using ICCs. RESULTS Sixty-eight patients from 7 centers participated. CT mean AGP was 21.37 mm (15.96-28.90 mm) right and 21.22 mm (15.87-28.70 mm) left (ICC 0.996 and 0.995). Exophthalmometry AGP fell between 18 mm and 25 mm. Intraclinician agreement across exophthalmometers was ideal (ICC 0.948-0.983). Agreement between clinicians was greater than 0.85 for all upright exophthalmometry measurements. Photographic mean AGP was 20.47 mm (10.92-30.88 mm) right and 20.30 mm (8.61-28.72 mm) left. Intrareader and interreader agreement was ideal (ICC 0.991-0.989). All exophthalmometers' mean differences from CT ranged between -0.06 mm (±1.36 mm) and 0.54 mm (±1.61 mm); 95% confidence interval fell within 1 mm. Magnitude of AGP did not affect exophthalmometry validity. Oculus best estimated CT AGP but differences from other exophthalmometers were not clinically meaningful in upright measurements. Photographic AGP (right ICC = 0.575, left ICC = 0.355) and palpebral fissure do not agree with CT. CONCLUSIONS Upright clinical exophthalmometry accurately estimates CT AGP in TED. AGP measurement was reliably reproduced by the same clinician and between clinicians at multiple institutions using the protocol in this study. These findings allow reliable measurement of AGP that will be of considerable value in future outcome studies.
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Affiliation(s)
- Chad M. Bingham
- West Virginia University Eye Institute, West Virginia University Department of Ophthalmology, Morgantown, WV, USA
| | - Jennifer A. Sivak-Callcott
- West Virginia University Eye Institute, West Virginia University Department of Ophthalmology, Morgantown, WV, USA
| | - Matthew J. Gurka
- West Virginia University Department of Biostatistics, Morgantown, WV, USA
| | - John Nguyen
- West Virginia University Eye Institute, West Virginia University Department of Ophthalmology, Morgantown, WV, USA
| | - Jeffery P. Hogg
- West Virginia University Department of Radiology, Morgantown, WV, USA
| | - Steve E. Feldon
- David and Ilene Flaum Eye Institute, University of Rochester Department of Ophthalmology, Rochester, NY, USA
| | - Aaron Fay
- Harvard University Department of Ophthalmology, Boston, MA, USA
| | | | - Diego Strianese
- Department of Neuroscience, Reproductive Science and Odontostomatology University Federico II, Naples, Italy
| | - Vikram D. Durairaj
- University of Colorado, Department of Ophthalmology, Denver, CO, Texas Oculoplastic Consultants, Austin, TX, USA
| | | | | | - Matheson Harris
- West Virginia University Eye Institute, West Virginia University Department of Ophthalmology, Morgantown, WV, USA
| | - Justin Saunders
- West Virginia University Eye Institute, West Virginia University Department of Ophthalmology, Morgantown, WV, USA
| | - Tammy H. Osaki
- Harvard University Department of Ophthalmology, Boston, MA, USA
| | | | - Livia Teo
- Singapore National Eye Centre, Singapore
| | - Brett W. Davies
- University of Colorado, Department of Ophthalmology, Denver, CO, Texas Oculoplastic Consultants, Austin, TX, USA
| | - Andrea Elefante
- Department of Advanced Biomedical Sciences, University Federico II, Naples Italy
| | - Sunny Shen
- Singapore National Eye Centre, Singapore
| | - Tony Realini
- West Virginia University Eye Institute, West Virginia University Department of Ophthalmology, Morgantown, WV, USA
| | - William Fischer
- David and Ilene Flaum Eye Institute, University of Rochester Department of Ophthalmology, Rochester, NY, USA
| | - Michael Kazim
- Harkness Eye Institute, Columbia University Department of Ophthalmology, New York, NY, USA
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Three-Dimensional Eyeball and Orbit Volume Modification After LeFort III Midface Distraction. J Craniofac Surg 2015; 26:1652-5. [DOI: 10.1097/scs.0000000000001601] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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13
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Erkoç MF, Öztoprak B, Gümüş C, Okur A. Exploration of orbital and orbital soft-tissue volume changes with gender and body parameters using magnetic resonance imaging. Exp Ther Med 2015; 9:1991-1997. [PMID: 26136927 DOI: 10.3892/etm.2015.2313] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 02/16/2015] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to examine the total orbital volume (TOV) and total orbital fat volume (TOFV) in normal orbits in different age groups and to investigate the correlation of these measurements with age, gender and body parameters by magnetic resonance imaging (MRI). MRI data were acquired retrospectively from a total of 1,453 subjects divided into five age groups with 10-year intervals. The TOV and TOFV were measured using T1-weighted MRI for each subject and body parameters were also obtained. The measurements demonstrated that TOV increased with age and that the volume was larger in men than in women. While weight and height exhibited positive correlations with TOV in male and female subjects in the 20-29, 30-39 and 40-49-year-old age groups, only weight showed a positive correlation with TOV in female subjects in the 50-59 and 60-69-year-old age groups. However, TOFV increased by age in all groups and the increments were larger in women than in men. These results provide basic information about the effect of age, gender and body parameters on TOV and TOFV. The variations in TOV are associated with orbital soft-tissues changes rather than with TOFV.
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Affiliation(s)
| | - Bilge Öztoprak
- Department of Radiology, Bozok Medical Faculty, Yozgat 66200, Turkey
| | - Cesur Gümüş
- Department of Radiology, Bozok Medical Faculty, Yozgat 66200, Turkey
| | - Aylin Okur
- Department of Radiology, Bozok Medical Faculty, Yozgat 66200, Turkey
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14
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Yoo JH, Lee YH, Lee H, Kim JW, Chang M, Park M, Baek S. Correlation between orbital volume, body mass index, and eyeball position in healthy East asians. J Craniofac Surg 2013; 24:822-5. [PMID: 23714888 DOI: 10.1097/scs.0b013e3182802600] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The objectives of this study were measure the orbital volume of healthy Koreans and analyze the differences between orbital tissue volume with respect to age and sex and to assess any correlation between body mass index (BMI), eyeball position, and orbital volume. METHODS We retrospectively evaluated the scan results of patients who had undergone orbital computed tomography scans between November 2010 and November 2011. We assessed the scan results of 184 orbits in 92 adults who had no pathology of the orbit. The individuals were classified into 3 groups with respect to age. Orbital volume, effective orbital volume (defined as the difference between orbital and eyeball volume), extraocular muscle volume, orbital fat volume, and transverse globe protrusion were recorded and analyzed. The records of the subjects were reviewed retrospectively, and BMI was calculated. A correlation analysis was performed to investigate the correlation between BMI, eyeball position, and orbital volume. RESULTS Orbital tissue volume, with the exception of orbital fat volume, was larger in men compared with women. In both sexes, orbital fat volume increased with increasing age, whereas the other volumes decreased. Orbital tissue volumes increased with increasing BMI, but transverse globe protrusion was not significantly related to BMI. In addition, orbital volume and effective orbital volume were positively correlated with transverse globe protrusion. CONCLUSIONS These results provide basic information about the effects of age, sex, and BMI on orbital volume and eyeball position in healthy Koreans. Furthermore, these results will be helpful in the diagnosis of orbital diseases and in planning orbital surgeries.
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Affiliation(s)
- Jun Ho Yoo
- Departments of Ophthalmology, Korea University College of Medicine, Seoul, Korea
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15
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Lee TT, Cho P. Relative peripheral refraction in children: twelve-month changes in eyes with different ametropias. Ophthalmic Physiol Opt 2013; 33:283-93. [DOI: 10.1111/opo.12057] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 03/11/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Tsui-Tsui Lee
- School of Optometry; The Hong Kong Polytechnic University; Kowloon; Hong Kong
| | - Pauline Cho
- School of Optometry; The Hong Kong Polytechnic University; Kowloon; Hong Kong
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16
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Guyomarc’h P, Stephan CN. The Validity of Ear Prediction Guidelines Used in Facial Approximation*,†,‡. J Forensic Sci 2012; 57:1427-41. [DOI: 10.1111/j.1556-4029.2012.02181.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Guyomarc'h P, Dutailly B, Couture C, Coqueugniot H. Anatomical placement of the human eyeball in the orbit--validation using CT scans of living adults and prediction for facial approximation. J Forensic Sci 2012; 57:1271-5. [PMID: 22390613 DOI: 10.1111/j.1556-4029.2012.02075.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Accuracy of forensic facial approximation and superimposition techniques relies on the knowledge of anatomical correlations between soft and hard tissues. Recent studies by Stephan and collaborators (6,8,10) reviewed traditional guidelines leading to a wrong placement of the eyeball in the orbit. As those statements are based on a small cadaver sample, we propose a validation of these findings on a large database (n = 375) of living people. Computed tomography scans of known age and sex subjects were used to collect landmarks on three-dimensional surfaces and DICOM with TIVMI. Results confirmed a more superior and lateral position of the eyeball relatively to the orbital rims. Orbital height and breadth were used to compute regression formulae and proportional placement using percentages to find the most probable position of the eyeball in the orbit. A size-related sexual dimorphism was present but did not impact on the prediction accuracy.
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Affiliation(s)
- Pierre Guyomarc'h
- Université Bordeaux 1, UMR 5199-PACEA, Anthropologie des Populations Passées et Présentes (A3P), Talence, France.
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