Interocular Posterior Retinal Curvature Asymmetry and Its Relationship With Myopic Differences in Anisometropic...

To investigate interocular differences in posterior retinal curvature in anisometropic children and their association with interocular differences in myopia.

Forty-two non-highly myopic children underwent ultra-widefield swept-source optical coherence tomography for 24-mm × 20-mm macular-centered retinal imaging. Gaussian curvature measurements were derived from corrected three-dimensional retinal reconstructions, based on Bruch's membrane segmentation. The retina was divided into six regions (I-VI) with diameters of 1, 3, 6, 9, 12, and 15 mm according to the Early Treatment of Diabetic Retinopathy Study grid standard. Regions I to III were classified as the macular zone, while regions IV to VI constituted the peripheral zone.

The mean difference in spherical equivalent between the more myopic and less myopic eyes was 1.42 ± 0.51 diopters, while the difference in axial length (AL) was 0.58 ± 0.32 mm. The average retinal curvature in the macular zone was significantly steeper in the more myopic eyes (0.55 ± 0.15 × 10⁻² mm⁻²) compared to the less myopic eyes (0.46 ± 0.11 × 10⁻² mm⁻²; P < 0.001). Retinal curvature was significantly higher in regions I to IV of the more myopic eyes but lower in region VI (all P < 0.001). Furthermore, positive correlation was observed between macular retinal curvature disparities and AL differences (R = 0.340, P = 0.028), while peripheral retinal curvature disparities were negatively correlated with AL differences (R = -0.374, P = 0.015).

Axial elongation drives region-specific posterior retinal remodeling in anisometropic children, steepening the macula and flattening the periphery.

By investigating retinal curvature in anisometropic children, we provide morphologic insights that establish a basis for strategies to prevent and manage pediatric myopia.