Article Sidebar
Main Article Content
Abstract
Background: The escalating prevalence of high myopia represents a critical global health crisis, particularly in Southeast Asia. This pathological refractive status is driven by complex structural changes, primarily axial elongation, which predisposes the eye to sight-threatening complications. While the dominance of axial length in myopia is established, the compensatory role of the anterior segment—specifically whether the cornea or anterior chamber undergoes adaptive morphological changes to counteract elongation—remains a subject of debate. This study utilized high-resolution Swept-Source Optical Coherence Tomography (SS-OCT) to precisely quantify the relationship between Spherical Equivalent (SE) and ocular biometric parameters, isolating the specific contributions of posterior segment elongation versus anterior segment adaptation.
Methods: This observational analytic study with a cross-sectional design was conducted at the Ophthalmology Clinic of Dr. M. Djamil General Hospital, Padang, Indonesia. The study recruited patients aged 18–40 years diagnosed with high myopia (SE defined as -6.00 Diopters or worse). Strict exclusion criteria were applied to eliminate confounding anterior segment pathologies. Ocular biometry was performed using the IOLMaster 700, which employs Swept-Source OCT technology for full-eye length tomography. We analyzed Axial Length (AL), Mean Keratometry (K), Central Corneal Thickness (CCT), and Anterior Chamber Depth (ACD). Statistical analysis utilized Pearson and Spearman correlation tests and linear regression modelling.
Results: A total of 32 eyes from 32 high myopia patients were analyzed. The mean SE was -8.14 plus or minus 2.09 D, and the mean AL was 26.93 plus or minus 1.92 mm. We found a robust, statistically significant negative correlation between SE and AL (r = -0.86; p less than 0.001), confirming AL as the primary determinant of refractive severity. Notably, a moderate negative correlation was observed between AL and K (r = -0.41; p = 0.02), indicating a paradoxical corneal flattening in longer eyes. No significant correlations were found between SE and CCT or ACD.
Conclusion: Axial elongation is the predominant structural mechanism driving high myopia in this cohort. The study identified a distinct compensatory response where the cornea flattens as the eye elongates; however, this emmetropization mechanism is insufficient to neutralize the profound refractive shift caused by posterior segment expansion. These findings suggest that high myopia is a disease of focal posterior scleral remodelling rather than global ocular expansion.
Keywords
Article Details
As our aim is to disseminate original research article, hence the publishing right is a necessary one. The publishing right is needed in order to reach the agreement between the author and publisher. As the journal is fully open access, the authors will sign an exclusive license agreement.
The authors have the right to:
- Share their article in the same ways permitted to third parties under the relevant user license.
- Retain copyright, patent, trademark and other intellectual property rights including research data.
- Proper attribution and credit for the published work.
For the open access article, the publisher is granted to the following right.
- The non-exclusive right to publish the article and grant right to others.
- For the published article, the publisher applied for the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
