Refractive error is associated with intracranial volume.

Myopia is part of the spectrum of refractive error. Myopia is associated with psychometric intelligence and, the link between brain anatomy and myopia has been hypothesized. Here we aimed to identify the associations between brain structures and refractive error in developed young adults. In a study cohort of 1,319 normal educated young adults, the refractive error showed a significant negative correlation with total intracranial volume and total cerebrospinal fluid (CSF) volume but not with total gray matter volume (GMV) or total white matter volume (WMV). Time spent studying was associated with refractive error but could not explain the aforementioned associations with brain volume parameters. The R2 values of the simple regression between spherical equivalent and outcome variables for each sex in non-whole brain imaging analyses were less than 0.05 in all cases and thus were weak. Psychometric intelligence was not associated with refractive error or total CSF volume, but it weakly positively correlated with total GMV and total WMV in this study population. Thus, refractive error appears to be primarily (weakly) associated with the volume of the cranium, whereas psychometric intelligence was associated with the volume of the brain.