Regional retinal curvature remodeling and choroidal changes following posterior scleral reinforcement in high myopia: A quantitative multimodal imaging study.

PURPOSE: To quantitatively assess retinal curvature and microvascular changes following posterior scleral reinforcement (PSR) using the BM-400 K SS-OCTA system.

METHODS

This pilot study enrolled 21 highly myopic eyes undergoing PSR. Baseline and postoperative (1/3/6 months) assessments included best-corrected visual acuity (BCVA), spherical equivalent (SE), and axial length (AL). The BM-400 K system measured retinal curvature (RC), choroidal thickness (ChT), superficial/deep capillary plexus density (SCP/DCP), and choroidal vascular index (CVI).

RESULTS

Significant axial shortening occurred, peaking at 3 months (median AL: 27.98 mm vs. baseline 28.61 mm, P < 0.01). Progressive retinal flattening was observed (RC: 0.48 D/mm at 6 months vs. 0.77 D/mm baseline, P = 0.004). Strong correlations emerged between curvature changes (∆RC) and AL reduction (e.g., ∆RC3 vs. ∆AL at 6 months, rₛ=0.861, FDR-adj. P = 0.010). Notably, ∆RC correlated negatively with profound capillary density changes in specific regions (e.g., ∆RC4 vs. ∆DCP4, rₛ= -0.756, FDR-adj. P = 0.021).

CONCLUSION

BM-400K-based quantitative RC analysis demonstrates that PSR induces significant retinal flattening, which is linked to axial shortening and microvascular remodeling. This novel optical evaluation provides critical structural and hemodynamic insights for PSR outcome assessment.