Plaka Argyro D, Plainis Sotirios, Chatzakis Petros, Kontadakis Georgios, Markakis George, Kymionis George, Pallikaris Ioannis, Siganos Haralampos
Institute of Vision and Optics, Medical School, University of Crete, Heraklion, GRC.
First Department of Ophthalmology, "G. Gennimatas" Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Cureus. 2025 Mar 12;17(3):e80466. doi: 10.7759/cureus.80466. eCollection 2025 Mar.
To use a portable electromyographic (EMG) system for the objective evaluation of glare-induced discomfort in patients with keratoconus.
Fifty-five eyes of 31 patients and 24 controls were enrolled in this retrospective case-control study. The electrical activity of the mimic muscles was recorded at three different luminances (500, 3000, and 6000 lux) using a portable EMG system. A discomfort glare value was obtained as the signal/noise ratio for each recording. All the patients were asked to grade their discomfort after exposure to each luminance using the subjective de Boer scale. Corneal topography-based wavefront analysis, pupil size, and angle kappa were calculated to identify possible significant correlations.
Mean values of discomfort glare index (signal/noise ratio) for the patients' group were 1.66 ± 1.5 at 500 lux, 2.71 ± 1.68 at 3000 lux, and 3.16 ± 1.92 at 6000 lux; for the control group, 1.4 ± 0.4 at 500 lux, 1.9 ± 0.86 at 3000 lux, and 2.13 ± 0.9 at 6000 lux. There was a statistically significant difference at the level of 0.05 between the two groups only at the 6000-lux illuminance level. There was a significant Spearman's correlation at all luminances between the objective electromyographic recording and the subjective grading of the discomfort feeling. There were no statistically significant correlations between electromyographic responses and keratometric values, pupil size, or angle kappa. Trefoil and coma were significantly correlated with discomfort glare-estimated electromyographic values.
Patients with keratoconus experience higher levels of discomfort when exposed to a glare source, as measured objectively with electromyographic recordings, which may affect their quality of vision.
使用便携式肌电图（EMG）系统客观评估圆锥角膜患者眩光引起的不适。
本回顾性病例对照研究纳入了31例患者的55只眼和24名对照者。使用便携式EMG系统在三种不同亮度（500、3000和6000勒克斯）下记录表情肌的电活动。获得每个记录的不适眩光值作为信号噪声比。所有患者在暴露于每种亮度后使用主观de Boer量表对其不适程度进行分级。计算基于角膜地形图的波前分析、瞳孔大小和kappa角，以确定可能的显著相关性。
患者组在500勒克斯时不适眩光指数（信号噪声比）的平均值为1.66±1.5，在3000勒克斯时为2.71±1.68，在6000勒克斯时为3.16±1.92；对照组在500勒克斯时为1.4±0.4，在3000勒克斯时为1.9±0.86，在6000勒克斯时为2.13±0.9。两组之间仅在6000勒克斯照度水平下存在0.05水平的统计学显著差异。客观肌电图记录与不适感觉的主观分级在所有亮度下均存在显著的斯皮尔曼相关性。肌电图反应与角膜曲率值、瞳孔大小或kappa角之间无统计学显著相关性。三叶草像差和彗差与不适眩光估计的肌电图值显著相关。
圆锥角膜患者在暴露于眩光光源时会经历更高水平的不适，通过肌电图记录客观测量，这可能会影响他们的视觉质量。
