Abstract
PURPOSE: To investigate regional differences in Gaussian retinal curvature (RC) between fellow eyes of anisometropic patients and their associations with interocular disparities in myopic parameters. METHODS: In this cross-sectional study, ultra-widefield swept-source optical coherence tomography (24 mm × 20 mm field) was performed in 121 anisometropic patients. Three-dimensional retinal morphology reconstruction based on Bruch's membrane was used to derive Gaussian RC. The retina was segmented into macular, peripheral, and six concentric annular regions (I-VI). Paired t-tests or Wilcoxon signed-rank tests were applied to evaluate interocular RC differences, with Spearman correlation analysis examining associations between RC variations and myopic parameter disparities. RESULTS: Mean interocular differences were 1.95 ± 0.95 D for spherical equivalent (SE) and 0.79 ± 0.46 mm for axial length (AL). The more myopic eye exhibited significantly steeper macular RC (P < 0.001) and flatter peripheral RC (P < 0.001) compared to the fellow eye. Macular/peripheral RC disparities demonstrated significant correlations with SE/AL differences (both P < 0.05). Region-specific analysis revealed positive correlations between AL and RC I-III differentials, whereas inverse correlations were observed for RC V-VI (all P < 0.01). CONCLUSIONS: Anisometropic patients demonstrate biomechanical divergence characterized by macular steepening and peripheral flattening in the more myopic eye during axial elongation, suggesting region-dependent retinal adaptation mechanisms.