{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T06:05:00Z","timestamp":1780985100404,"version":"3.54.1"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"NIH"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Ophthalmol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To characterize reference margin-to-reflex distance 1 (MRD1) measurements across different demographic factors, age, sex, race, and ethnicity, using a large electronic health record-derived (EHR) dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a single-institution observational, cross-sectional study of adult patients seen in an academic oculoplastics division from October 2018 to June 2023. MRD1 values were extracted from structured data fields and free-text progress notes. Patients with diagnoses known to affect MRD1 (e.g. dermatochalasis, ptosis) were excluded from the study. Univariate analysis was conducted using one-way ANOVA and post hoc testing, while multivariable analysis testing was done through a linear mixed-effects regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 6231 patients and 11,932 reference MRD1 values were analyzed. MRD1 decreased by approximately 0.2\u00a0mm (mm) per decade of life (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Female sex was associated with higher MRD1 measurements (3.38 vs 3.003,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), while Asian race was associated with lower MRD1 values (2.99 vs 3.32,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MRD1 values vary significantly by age, sex, and race. These findings provide reference values for MRD1 within a clinical oculoplastics population accounting for demographic factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10792-026-04124-5","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T05:47:28Z","timestamp":1780984048000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Use of electronic health records to examine margin-to-reflex distance in patients without eyelid conditions affecting position"],"prefix":"10.1007","volume":"46","author":[{"given":"Jason W.","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fritz Gerald P.","family":"Kalaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharanidharan R.","family":"Saseendrakumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally L.","family":"Baxter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine Y.","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobby S.","family":"Korn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3738-3864","authenticated-orcid":false,"given":"Don O.","family":"Kikkawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"issue":"4","key":"4124_CR1","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1097\/IOP.0B013E3182523B7F","volume":"28","author":"AM Putterman","year":"2012","unstructured":"Putterman AM (2012) Margin reflex distance (MRD) 1, 2, and 3. 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