To explore the associated ocular parameters with lenticular myopia and assess the correlation between lens density and myopic shift. This retrospective cross-sectional study enrolled 50 patients with lenticular high myopia as the study group and 85 cases as the validation group. Lens density was obtained through swept-source optical coherence tomography (SS-OCT, IOLMaster 700) and measured by Image J software. Linear regression analysis and correlation analysis were applied to study the association between lenticular myopia and ocular variables. Receiver operating characteristic curves and calibration charts were plotted for nuclear density (ND) in identifying lenticular high myopia. Both ND and lens thickness were discovered to be associated with spherical equivalent refraction and lens power (p < 0.05); yet, only ND was significantly correlated with lenticular myopia, as the difference of nuclear density (NDdiff) between the lenticular myopic eye and the fellow eye was significantly correlated with the interocular difference of spherical equivalent refraction (SERdiff, r = - 0.752, p < 0.001) and the interocular difference of lens power (LPdiff, r = 0.834, p < 0.001). The ND is a good metric for diagnosing lenticular high myopia, with the area under curve (AUC) being 0.898 (0.821-0.949) and the cut-off value being 98.88 pixel units. The accuracy of the cut-off value in the validation group was 82.35%. Average ND quantified by IOLMaster 700 is not only associated with lenticular myopia but is a suitable metric for predicting the amount of myopic shift.