PURPOSE: To evaluate the relationship between retinal curvature (RC) and ocular biometry in patients with myopia. METHOD: The clinical data of 74 patients with myopia (148 eyes) were retrospectively analyzed. Macular 24×20 mm optical coherence tomography (OCT) scans were acquired using an ultra-widefield swept-source optical coherence tomography (UWF SS-OCT) system. The software then identified the Bruch's membrane and integrated it with the axial length (AL) for morphological correction, yielding a fitted three-dimensional retinal model. From this model, an RC map was generated, detailing the Gaussian curvature at each point. The maximum retinal curvature (RCmax) and central macular retinal curvature (RCc) were analyzed. RESULTS: A total of 148 eyes were analyzed. The analysis revealed that RCmax was negatively correlated with AL (r=-0.266, P <
0.05) and positively correlated with mean keratometry (Km) (r = 0.285, P <
0.05). RCc was also positively correlated with Km (r = 0.167, P <
0.05), whereas RCmax and RCc were positively correlated with each other (r = 0.450, P <
0.05). CONCLUSIONS: In eyes with large innate eyeballs (characterized by a smaller Km), the RCmax was smaller, and acquired axial elongation (characterized by a larger AL) led to a reduction in RCmax, and vice versa. Eyes with large innate eyeballs also showed a smaller RCc, and vice versa.