Assessment of anterior scleral thickness in myopes and emmetropes using anterior segment optical coherence tomography

To investigate the differences in anterior scleral thickness (AST) among the refractive statuses of Chinese adults aged 18-35.

This study recruited 170 Chinese participants (mean age, 24.06 ± 2.78 years), including myopes (spherical equivalent refraction [SER] -1.00 to -12.75 diopters [D]; n = 134), emmetropes (SER ± 0.75 D; n = 36), and AST (superior, inferior, nasal, and temporal), which were investigated via swept-source optical coherence tomography. Semiautomated custom-designed software measured the scleral thickness from the scleral spur to 5 mm along four meridians.

The mean axial length and spherical equivalent refractive error were 25.12 ± 1.44 mm and -3.93 ± 3.09 D, respectively. The anterior sclera was thickest in the inferior region and thinnest in the superior region (753.9 ± 88.7 μm versus 613.6 ± 58.4; p < 0.001). The AST in the temporal meridian was significantly thicker than that in the nasal meridian (727.5 ± 60.8, 690.9 ± 55 μm; p < 0.001). There were no significant variations in AST in the myopes and emmetropes along the five latitude lines. AST along the inferior meridian at the 4-mm (r 2 = 0.0992; p < 0.001) and 5-mm (r 2 = 0.0888; p < 0.001) locations decreased significantly with increasing myopia.

With increased myopia, AST at the 4-mm and 5-mm locations showed significant thinning in the inferior meridian. The results indicate that AST, especially along the inferior meridian, may act as a biologic marker to monitor the progression of myopia.