Relationship Between Scheimpflug-Based Ocular Biomechanics and Myopic Maculopathy.

Ocular biomechanics may contribute to the variability of structural and functional outcomes in highly myopic eyes, but their role in myopic maculopathy remains unclear. This retrospective cohort study investigated whether in vivo corneal biomechanical parameters are associated with macular structural phenotypes and longitudinal functional changes. Fifty-four eyes with high myopia (≤-6 D; mean SE -15.6 ± 6.6 D) were evaluated at baseline and after 5.0 ± 0.1 years. Biomechanics were assessed with Corvis Scheimpflug Technology®, macular structure was assessed with SD-OCT (6 × 6 mm), and function was assessed with Microperimeter MP-3 (CPS, dB). Foveoschisis was associated with higher A2 deformation amplitude (0.371 vs. 0.333 mm, p = 0.014) and SSI (0.986 vs. 0.827, p = 0.035). Staphyloma showed changes in the highest concavity radius (7.13 vs. 6.17 mm, p = 0.002), A1 deformation amplitude (0.150 vs. 0.132 mm, p = 0.001), and maximum deflection amplitude (1.03 vs. 1.19 mm, p = 0.013). Softer corneal parameters correlated with less functional loss, while stiffer parameters correlated with greater decline; similar trends were observed for fixation stability. These findings suggest that biomechanical profiles may vary across macular phenotypes and could be associated with functional evolution in highly myopic eyes.