Xie Ruisi, Huo Yan, Li Yutong, Qu Zhengyuan, Zou Haohan, Wang Yan
School of Medicine, Nankai University, Tianjin, China.
Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.
Transl Vis Sci Technol. 2025 Jun 2;14(6):8. doi: 10.1167/tvst.14.6.8.
The purpose of this study was to evaluate the relationship between in vivo scleral thickness and biomechanical properties in eyes with myopia and to examine the association between in vivo sclera and the severity of myopia.
This prospective case series included 101 eyes from 101 patients with myopia. Corneal biomechanical parameters and anterior scleral images were acquired using the Corvis ST and anterior segment optical coherence tomography (AS-OCT), respectively. Anterior scleral thickness (AST) was measured at the scleral spur (AST0), and at 1 mm (AST1), 2 mm (AST2), and 3 mm (AST3) along the nasal (NAST) and temporal (TAST) regions. The correlations among corneal biomechanical parameters, AST, axial length (AL), and spherical equivalent refraction (SER) were analyzed after adjusting for confounding factors.
The scleral spur (AST0) was thicker than the other regions (P < 0.0001). After adjusting for confounding factors, the corneal biomechanical parameters, the stiffness parameter at highest concavity (SP-HC) was significantly related to scleral thickness (P < 0.05, rNAST0 = 0.369, rNAST1 = 0.236, rNAST2 = 0.217, and rTAST0 = 0.480). SP-HC (r = 0.223) and peak distance (r = -0.259) were significantly related to SER (P < 0.05).
Scleral thickness, particularly at the scleral spur, is an important factor influencing in vivo biomechanics of myopic eyes. The stiffness parameter SP-HC showed the strongest correlation with in vivo AST, potentially reflecting scleral biomechanical properties. SP-HC decreased significantly with increasing myopia, suggesting that weaker scleral biomechanics may be a risk factor for myopia progression.
In vivo stiffness parameter SP-HC may indirectly quantify scleral properties and serve as a high-risk biomechanical indicator to evaluate myopia progression.
本研究旨在评估近视眼中活体巩膜厚度与生物力学特性之间的关系，并研究活体巩膜与近视严重程度之间的关联。
本前瞻性病例系列研究纳入了101例近视患者的101只眼。分别使用Corvis ST和眼前节光学相干断层扫描（AS-OCT）获取角膜生物力学参数和前巩膜图像。在前巩膜嵴处（AST0）以及沿鼻侧（NAST）和颞侧（TAST）区域在1 mm（AST1）、2 mm（AST2）和3 mm处测量前巩膜厚度（AST）。在调整混杂因素后，分析角膜生物力学参数、AST、眼轴长度（AL）和等效球镜度（SER）之间的相关性。
前巩膜嵴（AST0）比其他区域更厚（P < 0.0001）。在调整混杂因素后，角膜生物力学参数中，最高凹度处的刚度参数（SP-HC）与巩膜厚度显著相关（P < 0.05，rNAST0 = 0.369，rNAST1 = 0.236，rNAST2 = 0.217，rTAST0 = 0.480）。SP-HC（r = 0.223）和峰值距离（r = -0.259）与SER显著相关（P < 0.05）。
巩膜厚度，尤其是在前巩膜嵴处，是影响近视眼活体生物力学的重要因素。刚度参数SP-HC与活体AST的相关性最强，可能反映了巩膜的生物力学特性。随着近视程度增加，SP-HC显著降低，表明巩膜生物力学较弱可能是近视进展的一个危险因素。
活体刚度参数SP-HC可能间接量化巩膜特性，并作为评估近视进展的高风险生物力学指标。
