Ocular biometry in isolated versus disease-associated high myopia in children and adolescents: A retrospective observational study.

BACKGROUND

Pediatric high myopia (HM) is increasingly recognized as a heterogeneous condition, arising either idiopathically or in association with underlying ocular or genetic disorders. Disease-associated HM may show distinct biometric characteristics, yet comparative data in children remain limited. This study characterized ocular biometry in isolated HM (IHM) and disease-associated HM related to familial exudative vitreoretinopathy (FEVR), myelinated retinal nerve fibers (MRNF), Stickler syndrome (SS), and epiretinal membrane (ERM).

METHODS

We retrospectively analyzed patients aged ≤ 18 years with HM, defined as spherical equivalent (SE) ≤ - 5.0 diopters (D) or axial length (AL) ≥ 26.0 mm, who underwent comprehensive examinations. Biometric parameters were obtained using the IOLMaster 700. Linear mixed-effects models accounted for inter-eye correlation, and estimated marginal means with Benjamini-Hochberg-adjusted pairwise comparisons were used for statistical inference.

RESULTS

A total of 131 patients (186 eyes) were included. Of 186 affected eyes, 37.1% had extreme HM. Biometric differences were observed between IHM and disease groups: MRNF eyes had larger white-to-white diameters and lower astigmatism. FEVR eyes had shorter axial length, shallower anterior chambers, and steeper corneas. SS eyes showed thinner lenses, flatter corneas, and higher VCD: AL ratios. ERM eyes had shorter AL and deeper anterior chambers.

CONCLUSIONS

Distinct etiologies of pediatric HM demonstrate characteristic biometric signatures. While MRNF resembles IHM, FEVR, ERM, and SS show unique anterior and posterior segment alterations that may improve diagnostic accuracy and individualized management.