Amygdala Connectivity Alterations in High Myopia: A Resting-State fMRI Study with SVM-Based Classification.

Background: High myopia (HM) is strongly linked to emotional disorders like anxiety and depression. While prior neuroimaging findings in HM are varied, the role of the amygdala-the brain's core emotion center-remains critically under-explored. Given evidence of limbic system changes in other ophthalmic disorders (eg, glaucoma), we investigated amygdala-specific functional connectivity (FC) in HM. Methods: We acquired resting-state fMRI data from 82 HM patients and 59 healthy controls (HCs). Using a seed-based approach with the bilateral amygdalae, whole-brain FC was compared between groups. A support vector machine (SVM) then evaluated the classification power of the identified FC alterations. Results: Compared to HCs, HM patients showed significantly increased FC between the amygdala and key regions in the visual, default mode, and executive control networks, including the calcarine fissure, precuneus, and middle frontal gyrus. SVM models achieved robust classification performance, with an area under the curve (AUC) up to 0.765. Conclusion: This study provides the first report on amygdala-centric network reorganization in HM. These FC patterns show potential as neuroimaging biomarkers. Our findings offer preliminary evidence for a neural substrate underlying the emotional and cognitive dysregulation in HM, highlighting the need to address mental health in these patients.