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Comparative study of three exophthalmometers and computed tomographic biometry
Author(s) -
DELMAS J,
MARTIN S,
LOUSTAU JM,
BOURMAULT L,
ADENIS JP,
ROBERT PY
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.t117.x
Subject(s) - intraclass correlation , reproducibility , limits of agreement , medicine , nuclear medicine , clinical practice , reliability (semiconductor) , computed tomography , mathematics , radiology , statistics , physics , family medicine , power (physics) , quantum mechanics
Purpose Accurate and reproducible exophthalmometry is recognized as having a great importance in the clinical setting. However many variations are described among the different commercially available exophthalmometers. Methods In this prospective study, 3 exophthalmometers (Luedde’s, 2 mirrors Hertel’s, and 1 prism Mourits’ exophthalmometers) were compared to tomodensitometric biometry by 2 observers, for 60 patients. Data recorded were the external prebicanthal segment (EPBCS), the inter‐orbital distance (IOD) and the axial length of the globe (AL). Intraobservers and interobservers reproducibility were evaluated, using intraclass correlation coefficient (ICC) and Bland and Altman method. Results Concerning agreement between EPBCS measurements and CT‐scan biometry, ICC for Luedde’s instrument was 0.59 and 0.64 respectively for the 2 observers, for Hertel’s exophthalmometer: 0.63 and 0.72 and for Mourits’exophthalmometer: 0.94 and 0.87. Intraobserver and interobservers reproduciblities were high, particularly for Mourits’ exophthalmometer, concerning EPBCS and IOD measurements. Moreover, Bland and Altman charts showed that Luedde’s instrument induced underestimation of the readings, Hertel’s exophthalmometer overestimated small values and underestimated high values, and Mourits’ exophthalmometer slightly underestimated the readings compared to CT‐scan biometry. Conclusion We showed a greater accuracy with 1 prism Mourits’ exophthalmometer, whereas Luedde’s instrument has a moderate agreement with CT‐scan biometry and Hertel’s exophthalmometer intermediate results. Intra‐ and interobservers reliability were good. International selection of reliable exophthalmometers should be defined for clinical practice and studies.