Reliability of periocular anthropometry using three-dimensional digital stereophotogrammetry

  • Yongwei Guo
  • Alexander C. Rokohl
  • Friederike Schaub
  • Xiaoyi Hou
  • Jinhua Liu
  • Yue Ruan
  • Renbing Jia
  • Konrad R. Koch
  • Ludwig M. HeindlEmail author
Oculoplastics and Orbit



Non-invasive three-dimensional (3D) stereophotogrammetry is becoming increasingly popular in many fields. However, few studies have focused on its periocular application. We aimed to provide evidence for the periocular application of a novel anthropometric procedure using 3D stereophotogrammetry by evaluating its reliability.


Fifty-one Caucasians were recruited (102 eyes; mean age, 31.9 ± 13.6 years). Two sets of 3D images were acquired for each subject, and two measurement sessions were performed on each image by two raters. Fifty-two periocular landmarks were identified, and then 49 corresponding linear, curvilinear, and angular measurements were evaluated for intrarater, interrater, and intramethod reliability.


Our findings showed highly reliable results for mean absolute difference (0.59 and 0.68 unit), relative error measurement (2.66% and 3.08%), technical error of measurement (0.59 and 0.66 unit), relative technical error of measurement (2.71% and 2.96%), and intraclass correlation coefficient (0.98) for intrarater 1 and intrarater 2 reliability; respectively 0.94 unit, 4.06%, 0.89 unit, and 3.94%, as well as 0.97 for interrater reliability; and respectively 0.98 unit, 4.66%, 0.96 unit, and 4.64%, as well as 0.96 for intramethod reliability.


This imaging system and the landmark identification protocol are highly reliable. The collected measurements and their errors can be applied for the comparison of reliability among various 3D imaging systems and populations. It could be utilized for planning surgeries and evaluating treatment outcomes for physicians in ophthalmology, plastic and esthetic surgery, and in the maxillofacial field where periocular morphology alterations are made.


Three-dimensional anthropometry Periocular morphology Eyelid Brow Reliability Precision 


Funding information

This study receives a funding support by the Koeln Fortune Program/Faculty of Medicine, University of Cologne, Germany (Nr. 2680148101) and State Scholarship Fund from China Scholarship Council (Nr. 201708080141).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

417_2019_4428_MOESM1_ESM.xlsx (22 kb)
Online Resource 1 Intrarater, interrater and intramethod reliability estimates of MAD, TEM, REM, %TEM, total EM, and %total TEM across all measurement categories (XLSX 21 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Yongwei Guo
    • 1
  • Alexander C. Rokohl
    • 1
  • Friederike Schaub
    • 1
  • Xiaoyi Hou
    • 1
  • Jinhua Liu
    • 1
  • Yue Ruan
    • 1
  • Renbing Jia
    • 2
  • Konrad R. Koch
    • 1
  • Ludwig M. Heindl
    • 1
    • 3
    Email author
  1. 1.Department of Ophthalmology, Faculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany
  2. 2.Department of Ophthalmology, Ninth People’s Hospital, School of MedicineShanghai Jiao Tong UniversityShanghaiChina
  3. 3.Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne-DuesseldorfCologneGermany

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