Normal Values of Hertel Exophthalmometry in a Chinese Han Population from Shenyang, Northeast China

Overview

Journal Sci Rep

Specialty Science

Date 2015 Feb 24

PMID 25703959

Citations 15

Authors

Dan Wu

Xin Liu

Di Wu

Xin Di

Haixia Guan

Zhongyan Shan

Weiping Teng

Affiliations

Soon will be listed here.

Abstract

Aims of this study were to determine the normal range of absolute and relative Hertel exophthalmometric values (EVs) in a Chinese Han population. This population-based cross-sectional study consisted of 2010 healthy Han Chinese (1051 females and 959 males) aged between 8-87 years living in Shenyang, Northeast China, including 515 children (aged 8-14 years), 517 teenagers (aged 15-19 years), 582 adults (aged 20-69 years) and 396 elderly (aged 70-87 years). A Hertel exophthalmometer was used by the same physician for the measurement of EV and inter-orbital distance (IOD). For the entire study population, the Hertel EVs ranged from 10 mm to 22 mm; the mean EVs for the left eye (OS) and right eye (OD) were 15.0 ± 1.9 mm and 15.0 ± 2.0 mm, respectively; the upper normal limits of the EVs (mean + 2 SD) for OS and OD were 18.8 mm and 19.0 mm, respectively; the mean relative EV was 0.20 ± 0.43 mm. Age, but not sex, had a significant effect on the EV. We concluded that our study provides normative ophthalmic data in a Chinese Han population. The normal EVs, asymmetry and IOD values have been established for clinical reference.

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References

Kashkouli M, Nojomi M, Parvaresh M, Soltan Sanjari M, Modarres M, Noorani M . Normal values of hertel exophthalmometry in children, teenagers, and adults from Tehran, Iran. Optom Vis Sci. 2008; 85(10):1012-7. DOI: 10.1097/OPX.0b013e3181890dc7. View

Kaye S, Green J, Luck J, LOWE K . Dependence of ocular protrusion, asymmetry of protrusion and lateral interobital width on age. Acta Ophthalmol (Copenh). 1992; 70(6):762-5. DOI: 10.1111/j.1755-3768.1992.tb04884.x. View

Sodhi P, Gupta V, Pandey R . Exophthalmometric values in a normal Indian population. Orbit. 2002; 20(1):1-9. DOI: 10.1076/orbi.20.1.1.2647. View

Fledelius H, Stubgaard M . Changes in eye position during growth and adult life as based on exophthalmometry, interpupillary distance, and orbital distance measurements. Acta Ophthalmol (Copenh). 1986; 64(5):481-6. DOI: 10.1111/j.1755-3768.1986.tb06958.x. View

Amino N, Yuasa T, Yabu Y, Miyai K, KUMAHARA Y . Exophthalmos in autoimmune thyroid disease. J Clin Endocrinol Metab. 1980; 51(6):1232-4. DOI: 10.1210/jcem-51-6-1232. View

Mourits M, Lombardo S, van der Sluijs F, Fenton S . Reliability of exophthalmos measurement and the exophthalmometry value distribution in a healthy Dutch population and in Graves' patients. An exploratory study. Orbit. 2004; 23(3):161-8. DOI: 10.1080/01676830490504089. View

Dunsky I . Normative data for hertel exophthalmometry in a normal adult black population. Optom Vis Sci. 1992; 69(7):562-4. DOI: 10.1097/00006324-199207000-00009. View

Ahmadi H, Shams P, Davies N, Joshi N, Kelly M . Age-related changes in the normal sagittal relationship between globe and orbit. J Plast Reconstr Aesthet Surg. 2007; 60(3):246-50. DOI: 10.1016/j.bjps.2006.07.001. View

Bolanos Gil de Montes F, Perez Resinas F, Rodriguez Garcia M, Gonzalez Ortiz M . Exophthalmometry in Mexican adults. Rev Invest Clin. 2000; 51(6):341-3. View

10.

ODonnell N, Virdi M, Kemp E . Hertel exophthalmometry: the most appropriate measuring technique. Br J Ophthalmol. 1999; 83(9):1096B. PMC: 1723196. DOI: 10.1136/bjo.83.9.1096b. View

11.

Tsai C, Kau H, Kao S, Hsu W . Exophthalmos of patients with Graves' disease in Chinese of Taiwan. Eye (Lond). 2005; 20(5):569-73. DOI: 10.1038/sj.eye.6701925. View

12.

Kashkouli M, Beigi B, Noorani M, Nojoomi M . Hertel exophthalmometry: reliability and interobserver variation. Orbit. 2003; 22(4):239-45. DOI: 10.1076/orbi.22.4.239.17245. View

13.

Chan W, Madge S, Senaratne T, Senanayake S, Edussuriya K, Selva D . Exophthalmometric values and their biometric correlates: The Kandy Eye Study. Clin Exp Ophthalmol. 2009; 37(5):496-502. DOI: 10.1111/j.1442-9071.2009.02087.x. View

14.

Bilen H, Gullulu G, Akcay G . Exophthalmometric values in a normal Turkish population living in the northeastern part of Turkey. Thyroid. 2007; 17(6):525-8. DOI: 10.1089/thy.2006.0279. View

15.

Musch D, Frueh B, Landis J . The reliability of Hertel exophthalmometry. Observer variation between physician and lay readers. Ophthalmology. 1985; 92(9):1177-80. DOI: 10.1016/s0161-6420(85)33880-0. View

16.

Bahn R . Graves' ophthalmopathy. N Engl J Med. 2010; 362(8):726-38. PMC: 3902010. DOI: 10.1056/NEJMra0905750. View

17.

Smolders M, Graniewski-Wijnands H, Meinders A, Fogteloo A, Pijl H, de Keizer R . Exophthalmos in obesity. Ophthalmic Res. 2004; 36(2):78-81. DOI: 10.1159/000076885. View

18.

Sleep T, Manners R . Interinstrument variability in Hertel-type exophthalmometers. Ophthalmic Plast Reconstr Surg. 2002; 18(4):254-7. DOI: 10.1097/00002341-200207000-00004. View

19.

Segni M, Bartley G, Garrity J, Bergstralh E, Gorman C . Comparability of proptosis measurements by different techniques. Am J Ophthalmol. 2002; 133(6):813-8. DOI: 10.1016/s0002-9394(02)01429-0. View

20.

Quant J, Woo G . Normal values of eye position and head size in Chinese children from Hong Kong. Optom Vis Sci. 1993; 70(8):668-71. DOI: 10.1097/00006324-199308000-00015. View