Quantitative analysis of novel eyelid contour-based indices of blepharoptosis
Seyed Mohsen Rafizadeh1 *, Elias Khalili Pour 2 , Hamid Riazi-Esfahani 2 , Tahereh Mahmoudi 3 , Samin Khannejad4
- Orbital and Oculoplastic Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
- Retina service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract: To investigate novel indices for characterizing eyelid contour in patients with blepharoptosis.
Methods: The study had a total of 106 subjects who were categorized into four distinct groups: control (no ptosis), mild ptosis, moderate ptosis, and severe ptosis. The study employed image processing techniques to compute three indices, namely the Upper Nasal Index (UNI), Upper Temporal Index (UTI), and Upper Lid Contour Circularity Index (ULCCI), using full-face digital photographs.
Results: A total of 106 participants were divided into four groups: control (no ptosis), mild ptosis, moderate ptosis, and severe ptosis. The mean and inter-eye ratio values for all three indices were significantly different between the groups, with p<0.001 for all three comparisons. Pairwise comparisons revealed that UNI values were significantly different between the control and mild (p=0.008), moderate (p<0.001), and severe (p<0.001) groups. Similarly, UTI values were significantly different between the control and moderate (p<0.001) and severe (p<0.001) groups, but not between the control and mild groups (p>0.05). ULCCI values were significantly different between the control and moderate (p=0.006) and severe (p=0.001) groups, but not between the control and mild groups (p>0.05). The inter-eye ratio was significantly different between the control and mild (p=0.005), moderate (p<0.001), and severe (p<0.001) groups for UNI, between the control and moderate (p<0.001) and severe (p<0.001) groups for UTI, and between the control and severe (p<0.001) groups for ULCCI.
Conclusion: This study used three unique indicators (UNI, UTI, and ULCCI) to identify normal eyes from different severity levels of ptosis. Overall, the results of this study suggest that there is a significant association between mild, moderate, and severe ptosis and UNI, UTI, and ULCCI indices. The ratios of the upper nasal segment of the eye to the upper nasal circle allowed UNI to discriminate all ptosis grades from the control group.
