The aim of this study was to investigate the macular scleral thickness in super-high myopic eyes (spherical equivalent ≥ -9.00 D) of adults and estimate the correlation among scleral thickness with age, axial length, spherical equivalent and best corrected visual acuity.

195 eyes of 112 adults, among whom with super-high myopia included in this study from June 2016 to May 2018 in Guangzhou Aier Eye Hospital was 84 eyes from 50 males and 111 eyes from 62 females. The age ranged from 18 to 67, with an averaged of (33.10±13.27). Swept-source optical coherence tomography wasused to measure the macular scleral thickness among 7 meridians in a 500 μm intervals and range of 1500 μm for each from fovea toward temporal and nasal lateral, totally 7 sites. The differences of the macular scleral thickness in adults with super-high myopic were observed and the correlation of the scleral thickness with age, spherical equivalent, axial length, and best corrected visual acuity were analyzed.

The average of best corrected visual acuity, spherical equivalent, and axial length was (0.68±0.31) with the interval of 0.01—1.00; (-14.68±4.31) D with the interval of -9.00—-25.25 D; and (29.14±2.06) mm with the interval of 25.20—36.0 mm, respectively. The scleral thickness at 1500 μm from fovea toward temporal lateral was thinnest [(281.17±93.84) μm], while thickest at macula central fovea [(318.13±87.49) μm]. The scleral thickness at 1500 μm from fovea toward temporal lateral was thinner than that at 500 μm from fovea toward temporal lateral, macula central fovea, and nasal lateral (t=-2.78, -3.90, -3.37, -2.85, -3.07; P<0.05). The scleral thickness at 1000 μm from fovea toward temporal lateral was thinner than that at macula central fovea, 500 μm and 1500 μm from fovea toward nasal lateral (t=-2.87, -2.35, -2.05; P<0.05). The scleral thickness at the macula central fovea was slightly negatively correlated with age and moderately with axial length (r=-0.371, -0.573; P<0.05); while, moderately positively with spherical equivalent and best corrected visual acuity (r=0.469, 0.414; P<0.05). Multivariant analysis showed that axial lengthand age (β=-18.436, -1.347; P<0.05) were independent factors affecting the scleral thickness.

Swept-source optical coherence tomography is noninvasive and feasible to measure the scleral thickness of macula in adults with super-high myopia. The results indicates that abnormality of the sclera might play a role in the development of complication of super-high myopia. Measuring the macular scleral thickness in adults with super-high myopia could be regarded as one of the important indicators for the observation on posterior staphyloma, which provides an objective basis for the prevention and control of high myopia.