Beyond Spherical Equivalent and Axial Length in Myopia

Abstract

<p>Myopia is a public health threat with an increasing prevalence worldwide, including East Asia.Most individuals with myopia have excessive globe elongation. The greater the elongation is, the greater are the risks of vision-threatening complications, such as myopic macular degeneration including choroidal neovascularization, vitreoretinal interface abnormalities including peripheral retinal tears or detachments, and glaucoma. While axial length and spherical equivalent refraction remain cornerstones of clinical evaluation, their limitations in capturing posterior-segment heterogeneity underscore the need for biomarkers that reflect individual anatomical risk. The study by Yii et al addresses this gap by introducing fundus refraction offset (FRO), a deep learning–derived metric that quantifies the mismatch between fundus anatomy and on-axis refractive profile. The concept seems innovative and supported by initial results.<br></p>