Association between corneal biomechanics and retinal microvascular perfusion in myopic eyes with ocular hypertension: An OCTA and Corvis ST study.

PURPOSE: To investigate the associations between corneal biomechanics and retinal microvascular perfusion in the optic disc and macular regions in myopic eyes with ocular hypertension (OHT) without glaucomatous structural or functional damage.

PATIENTS AND

METHODS

This prospective cross-sectional study included 23 myopic eyes with OHT and 57 myopic eyes. Optical coherence tomography angiography (OCTA) quantified superficial and deep whole-image vessel density (wiVD) in the optic disc and macula. Corneal visualization scheimpflug technology (Corvis ST) was used to assess corneal biomechanics. Multivariable linear regression was performed to evaluate independent associations between corneal biomechanical parameters and wiVD in the myopic OHT group, after adjusting for age, axial length, biomechanically corrected intraocular pressure (bIOP), and central corneal thickness.

RESULTS

Compared to controls, myopic OHT eyes exhibited stiffer corneal biomechanical behavior and a tendency toward reduced wiVD. In OHT eyes, multivariable analysis showed A1 Deflection Amplitude was independently associated with superficial optic disc wiVD (B = 199.25, P = 0.049). A2 Deflection Amplitude was independently associated with both deep optic disc wiVD (B = 314.26, P = 0.001) and deep macular wiVD (B = 170.80, P = 0.011). Additionally, Deformation Amplitude Ratio (2 mm) was associated with superficial macular wiVD (B = 0.70, P = 0.035).

CONCLUSIONS

Myopic eyes with OHT exhibit stiffer corneal biomechanics before detectable glaucomatous damage. This stiffness is associated with a tendency toward reduced retinal microvascular perfusion, suggesting a link between early biomechanical alterations and microcirculatory changes.