This study investigates whether the myopia control efficacy of Peripheral Defocus spectacle lenses (PDL), as established in controlled trials, holds true in a real-world clinical environment. This single centre, retrospective study analysed clinical records from the University Eye Hospital Basel (2019 - 2024). Patients included had myopia diagnosis, had undergone at least three axial eye length measurements (approximately at 6, 12 and 18 months after starting therapy), and were treated with either PDL or Single Vision (SV) spectacle lenses exclusively, with no concurrent myopia treatments (e.g., atropine or contact lenses). Axial elongation and spherical equivalent (SE) were compared using independent t-tests. Statistical significance was set at p < .05. Of 177 patients, 30 were treated with PDL and 37 with SV lenses. Compared to SV lenses, PDL lenses significantly reduced axial elongation over 6, 12, and 18 months. At 6 months, average axial elongation in the left eye was 0.024 mm (CI: 0.007 - 0.041) in the PDL group compared to 0.101 mm (CI: 0.082 - 0.140) in the SV group (p = 0.005); in the right eye, - 0.003 mm (CI: - 0.040 - 0.034) vs. 0.112 mm (CI: 0.081 - 0.143) (p < 0.001). At 12 months, average axial elongation in the left eye was 0.088 mm (CI: 0.036 - 0.140) with PDL vs. 0.167 mm (CI: 0.119 - 0.215) with SV (p < 0.05); in the right eye 0.080 mm (CI: 0.029 - 0.131) vs. 0.191 mm (CI: 0.146 - 0.236) (p < 0.005).At 18 months, left eye elongation was 0.110 mm (CI: 0.028 - 0.192) with PDL vs. 0.229 mm (CI: 0.182 - 0.276) with SV; right eye 0.078 mm (CI: 0.008 - 0.148) vs. 0.254 mm (CI: 0.208 - 0.300) (p < 0.001 for both).No significant differences in SE were observed at 6 or 12 months. A significant difference in right eye SE was noted at 18 months (p = 0.044); however, no consistent trend emerged. This study confirms that PDL lenses significantly reduce myopic axial elongation compared to SV lenses in a real-world clinical setting. These results reinforce prior controlled trial findings and support the clinical adoption of PDL for effective myopia management.

To investigate the association between perforating scleral vessels (PSVs) and choriocapillaris (CC) flow deficits (CCFDs) in otherwise healthy myopic eyes, and to identify predictors of localized flow deficits at PSV entry sites. PSVs were localized using a combined en face and B-scan approach from swept-source OCTA volumes. CCFD% were quantified from signal-compensated 16-µm en face slabs using the Phansalkar method. Outcome measures included flow deficits at PSV sites (FDPSV), within 250 µm (FD250), and total CCFD. Mixed-effects regression was used to assess associations with demographic, refractive, and anatomic factors. Fifty-two eyes from 31 healthy myopic (≤-0.5D) participants were included in the study. A total of 119 PSVs were identified. Correlation analyses demonstrated significant associations between FDPSV and age, axial length (AXL), and global CCFD (P < 0.05). In univariable analysis, older age and higher global CCFD (P < 0.001) were associated with increased FDPSV. In multivariable analysis, age (β = 0.23, P = 0.045), global CCFD (β = 1.02, P < 0.001), and PSV area (β = 16.5, P = 0.009) were significant predictors of FDPSV. AXL was inversely associated with FDPSV (β = -2.37, P = 0.010). Localized CCFDs were consistently observed at PSV sites in myopic eyes. Although higher age, global CCFD, and PSV area were associated with greater localized deficits, longer AXL was associated with lower CCFDs, possibly reflecting scleral remodeling or altered PSV orientation in more significant myopia. These findings highlight the relevance of PSVs as early modulators of CC flow before the development of pathologic myopia.

The Antihydrogen Experiment: gravity, Interferometry, Spectroscopy at CERN aims to measure the gravitational acceleration of antihydrogen (H) atoms to test the weak equivalence principle for antimatter systems. In the proposed approach, a pulsed H beam, produced via charge exchange between Rydberg positronium and antiprotons, traverses a moiré deflectometer comprising two equally spaced gratings followed by a position-sensitive detector. As the beam traverses the moiré setup, H may annihilate on the gratings or nearby structures, producing high-energy pions, or continue towards the position-sensitive detector. For a high-accuracy gravity measurement, precise knowledge of the beam profile and annihilation points is essential. We present results from a feasibility study of vertex reconstruction using modular J-PET detectors spanning the full axial length of the moiré setup. The generated pions, being minimum-ionising particles, follow straight paths. The adapted method is based on the consecutive registration of each pion, defining individual tracks in a pair of modules placed 10 cm apart. The hit positions are used to reconstruct the track direction, which is then projected back to estimate the spatial coordinates of the H annihilation vertex. For this feasibility study, we developed a customised Geant4-based simulation package and an analysis algorithm that implements a track-and-extrapolate algorithm to image the annihilation vertices.

To develop an early warning prediction model integrating clinical indicators, ocular structural parameters, and quantitative fundus imaging features for myopic retinal detachment (MRD) to enhance the accuracy and clinical utility of MRD risk screening, thereby providing a quantitative basis for intervention in high-risk populations. A retrospective analysis was performed on 352 patients with high myopic admitted the ophthalmology department between January 2020 and December 2023. The patients were randomly divided into a training set and a validation set at a 7:3 ratio. Twenty indicators were collected, including clinical and demographic data, ocular biometric parameters and fundus imaging and lesion assessment. Univariate analysis was used to screen MRD-related indicators, followed by least absolute shrinkage and selection operator (LASSO) regression for variable compression. Independent risk factors were identified through multivariate logistic regression. Random forest (RF), support vector machine (SVM), and logistic regression (LR) models were constructed using Python 3.9.0 and the sklearn library. Model performance was evaluated based on the receiver operating characteristic (ROC) curve and area under the curve (AUC), sensitivity, and specificity, with the optimal model selected and key predictive indicators analyzed. There was no statistically significant difference in the baseline data of patients between the training set and the validation set (P > 0.05). Through univariate analysis and logistic multivariate regression analysis, it was found that axial length (AL), central macular thickness, degree of vitreous liquefaction, area of retinal degeneration, and number of retinal breaks were independent risk factors for the occurrence of MRD (P < 0.05). The AUC of the RF model (0.890) was significantly higher than that of the LR model (0.813) and the SVM model (0.872), making it the optimal model. This study successfully constructed and verified an MRD early warning prediction model based on multi-dimensional indicators. The study identified AL, central macular thickness, degree of vitreous liquefaction, area of retinal degeneration, and number of retinal breaks as independent risk factors for MRD. This model provides clear guidance for clinicians to conduct risk stratification and formulate follow-up strategies, demonstrating high clinical applicability and promotion potential. Not applicable.

High myopia (HM), defined as a spherical equivalent refractive error ≤ -5.00 or ≤ -6.00 diopters or axial length (AL) ≥ 26.0 mm, is a significant public health concern with a rapidly increasing prevalence, particularly in East Asia. Beyond impaired uncorrected vision, HM is associated with sight-threatening structural changes, including myopic maculopathy, choroidal neovascularization, retinal detachment, and glaucoma. The overlapping and atypical presentations of these complications pose considerable diagnostic challenges, often delaying intervention and complicating clinical management. This review synthesizes current knowledge on HM, emphasizing the spectrum of ocular complications and the multifaceted diagnostic dilemmas encountered. We have summarized the application of conventional and emerging diagnostic techniques—such as optical coherence tomography (OCT), ultra-widefield imaging, and fluorescein angiography in the diagnosis of high myopia and highlight the growing role of artificial intelligence (AI) and machine learning in enhancing diagnostic accuracy, particularly through the analysis of retinal images and OCT data. AI-based systems demonstrate high sensitivity and specificity in detecting HM-related pathologies, offering potential for large-scale screening and early intervention. Future directions include the development of integrated multimodal imaging platforms, genetic and metabolic biomarkers, and AI-driven predictive models to support personalized management strategies. This comprehensive overview underscores the need for advanced, accessible diagnostic tools to alleviate the burden associated with high myopia.

Myopia has emerged as a major threat to the visual health of adolescents worldwide. Early intervention can effectively slow down the progression of myopia in adolescents. Tuina, a significant therapeutic method in traditional Chinese medicine, has shown promising clinical efficacy in delaying the progression of myopia; however, it lacks robust, large-scale, and standardized randomized controlled trials. This study aims to explore the efficacy and safety of Tuina therapy in managing myopia in adolescents, thereby providing solid evidence for the application of Tuina in the clinical treatment of myopia. The design of this study is a multicenter, randomized controlled clinical trial. We will include 62 myopic children from four hospitals, who will be randomly assigned in a 1:1 ratio to a Tuina experimental group and a drug-positive control group (tropicamide eye drops). Treatments in each group will be three times a week, for a total of 8 weeks. The Tuina therapy experimental group will receive 20 minutes of Tuina therapy per session, while the drug-positive control group will use tropicamide eye drops, administered every other day, with two drops per session. The primary outcome measures include uncorrected visual acuity and axial length, with secondary measures including refractive power and accommodative amplitude. Data will be collected on the day of enrollment and treatment (week 0), on the day of completion of the 4th and 8th weeks of treatment, and at the end of the 10-week follow-up. Adverse events will be monitored and recorded throughout the study, and statisticians will be blinded. Data will be analyzed using SPSS 28.0. This study has been funded, and recruitment began in June 2025; so far, there have been 29 participants, divided into the Tuina group of 16, and the drug-positive control group group of 13. The recruitment process will last until October 2026. Final manuscript submission should happen by December 2026. This study aims to evaluate the efficacy and safety of Tuina therapy in the treatment of myopic adolescents. We hypothesize that the therapeutic effect of Tuina therapy is non-inferior to that of tropicamide eye drops, with the added advantages of fewer side effects and stable long-term efficacy, thereby providing reliable evidence and support for the application of Tuina therapy in the management of myopia in adolescents. Chinese Clinical Trial Registry: ChiCTR2600116606.

To evaluate the effects and safety of auricular acupressure combined with periocular thumbtack needle (AATN) therapy for premyopia children. This multi-center, randomized, controlled trial was conducted in 8 Chinese hospitals, and 298 premyopic children aged 6 to 10 years were recruited between October 2020 and February 2022. Eligible participants were randomly assigned to the treatment group or the control group via a simple randomization method. All the participants in both groups were provided with standard intensive eye health instruction through phone calls, WeChat or hospital visits once a week, and the children in the treatment group received AATN therapy additionally. Following 12-week treatment, participants were followed up at 3-month intervals, with the entire study extending over a 9-month duration from baseline to the final assessment. The primary outcome was the mean change in spherical equivalent (SE) from baseline to 36 weeks. The secondary outcomes included the rate of children with stable myopia (MSR), uncorrected visual acuity (UCVA), axial length (AL), corneal curvature (CC), accommodative amplitude (AMP) and intraocular pressure (IOP) at baseline, 6,12, 24 and 36 weeks. Safety assessment included analysis of treatment-related adverse events (AEs), such as allergic reactions and skin damage. Totally, 298 children with premyopia were included, 151 in the treatment group and 147 in the control group. At the 36th week, the SE was -0.81±0.55 D in the control group and -0.65±0.44 D in the treatment group (P=0.002). The treatment group demonstrated superior SE control efficacy compared with the control group, with differences of -0.29±0.37 D and -0.49±0.44 D, respectively (P<0.01). The children in the treatment group achieved a MSR of 57.78% with more favorable outcome than 37.10% in the control group (P<0.01). The adjusted mean change in AMP from baseline to 9th month was 8.85±4.02 in the control group and 9.85±3.41 in the treatment group (P=0.018). AL increased by a mean of 0.35±0.28 mm in the control group and 0.20±0.42 mm in the treatment group (P=0.004). No significant differences in UCVA or CC were found between the two groups (P>0.05) and no AEs were reported. AATN therapy was effective for controlling the onset of myopia and SE, enhancing ocular accommodation, and mitigating AL. (Registration No. ChiCTR2000039299).

PurposeTo investigate effects of near work performed under short-wavelength “blue” and long-wavelength “red” light on choroidal thickness (CT) and axial length (AL).MethodsTwenty-five participants (9 myopes, 16 nonmyopes), aged 20 to 36 years, completed four visits, consisting of a 30-minute near-work task (5 D demand) under broadband, blue (457 nm), and red (628 nm) light, and a control distance viewing condition under broadband light. Right eye CT and AL were measured before and after the task and after 30-minute recovery using optical coherence tomography (Spectralis) and biometry (Lenstar). Dynamic accommodative responses (n = 11) were recorded under each light condition (Grand Seiko).ResultsCT decreased and AL increased after near work in broadband (mean ± SEM CT: −11 ± 2 µm, AL: +10 ± 3 µm, P < 0.01) and red light (CT: −6 ± 1 µm, AL: +7 ± 2 µm, P < 0.01) but not under blue light or the control condition (P > 0.05 for all). After recovery, CT and AL returned to baseline, except in blue light, where AL decreased compared to baseline (AL: −4 ± 2 µm, P = 0.04). The accommodative response was significantly reduced under blue light (P < 0.01).ConclusionsNear work under broadband and red light produced acute choroidal thinning and axial elongation. Blue light was associated with a posttask reduction in axial length and reduced accommodative response. Findings suggest that blue light may mitigate biomechanical stress on the posterior eye that is induced by sustained near work.

The rapid growth in the installation of new energy poses challenges to the stability of the power grid due to its volatility and intermittency. Coal-fired power plants have come to play an important role in flexible peak power regulation. Considering that the burner is the core of a pulverized coal boiler, this study proposes the application of reverse injection pulverized coal combustion technology to power plant burners to achieve better ignition and combustion stability. The results of numerical simulations combined with experimental verification indicate that for a single ignition stabilizer, recirculation zones can be formed on both sides of the primary pulverized coal pipe at the front cone, and a high-temperature flame is ejected at high speed at the outlet. As the secondary air temperature increases from 373 K to 533 K, the axial length of the high-temperature recirculation zone increases, corresponding to an increase in the average outlet flame temperature from 1510 K to 1672 K. Under different loads of the main pulverized coal burner, the high-temperature flame ejected from the stabilizer can quickly encounter and mix with the surrounding main pulverized coal airflow, thereby igniting it rapidly. This process establishes a high-temperature flame zone within the two-stage combustion chamber, demonstrating strong adaptability to load fluctuations. As the burner load decreases, the outlet airflow velocity decreases significantly and the high-speed zone area shrinks, and the two adjacent high-temperature zones initially formed at the outlet gradually merge into a larger high-temperature zone. Simultaneously, the upward deflection of the jet at the outlet weakens.

Ocular rigidity in eyes with experimental myopia.

Myopia is a major global health concern. To enable precision myopia management, we developed a Transformer-based artificial intelligence (AI) model, the Myopia Progression Predictive Model (MPPM), comprising two modules: the Natural Progression Module (NPM) for predicting untreated myopia progression and the Intervention Progression Module (IPM) for forecasting progression under specific interventions. NPM was trained on 1,109,827 refractive records from 304,353 children and adolescents, achieving high predictive accuracy for future spherical equivalent (SE) and axial length (AL) over a 10-year period. In the internal test set, SE prediction reached R² = 0.94, MAE = 0.35D; for AL, R² = 0.91, MAE = 0.16 mm. Comparable performance was observed in external validation. IPM was trained on four intervention cohorts (0.01% atropine, orthokeratology, peripheral defocus spectacles, and repeated low-level red light [RLRL] therapy) using a Transformer-based causal machine learning framework, enabling individualized estimation of treatment effects. It accurately predicted myopia changes under each intervention (SE: R² > 0.88, MAE < 0.45D; AL: R² > 0.80, MAE < 0.31 mm). Among the interventions, RLRL slightly reversed myopia progression, whereas the others slowed myopia progression. MPPM demonstrates strong promise as an AI-driven platform for personalized prediction and optimization of pediatric myopia management.

Effect of Eye-Transcutaneous Electrical Acupoint Stimulation on Myopia Incidence in Children: A Randomized Clinical Trial.

To report visual and anatomical outcomes following intravitreal hydroxypropylmethylcellulose (HPMC) for the treatment of chronic structural hypotony. This study is a prospective interventional case series. Eight patients with chronic structural hypotony for more than 3 months, defined by an intraocular pressure (IOP) of <6.5 mm Hg. All patients had evidence of visual potential, clear cornea and a clear visual axis.Patients received multiple intravitreal HPMC injections (70 µL-1400 µL), administered every 2-4 weeks until either pre-morbid axial length was achieved, an IOP of 10-15 mm Hg was sustained for 4 weeks without signs of hypotony, or axial length of the contralateral eye was reached. They were followed up for 12 months after the first intravitreal injection. Best corrected visual acuity (BCVA) logarithm of the minimum angle of resolution (LogMAR) improved in 87.5% of eyes, with one eye remaining stable. The initial BCVA range was 0.3-1.7 LogMAR, and the final range was 0.1-1.6 LogMAR. IOP increased in 87.5% of eyes, from an initial range of 1-5 mm Hg to 3-23 mm Hg. Axial length increased in 75% of eyes, with a median increase of 1 mm (range 0.6-2.9 mm).Two adverse events occurred: uveitis flare-ups leading to loss of HPMC clarity in two eyes, managed with topical and intravitreal steroids, and two cases of temporary vision loss post-injection, resolved after paracentesis. This is the first case series to use a structured protocol for intravitreal HPMC in chronic hypotony management. The treatment improved vision and restored ocular anatomy, showing promise for managing structural hypotony in eyes with visual potential.

This study investigated whether short-term exposure to cyan light can inhibit axial elongation and choroidal thinning induced by myopigenic hyperopic defocus in humans. Thirteen myopes (-3.73 ± 1.21 D) and fifteen emmetropes (-0.05 ± 0.11 D), aged of 24.07 ± 3.54 years, were exposed to cyan light (507nm; total irradiance 3.06W/m2) and broadband light (3.05W/m2) using light-emitting glasses for two hours on separate days. Hyperopic defocus (-3D) was imposed on right eye using contact lenses (CL), while the fellow eye experienced no defocus. Ocular biometry, including axial length (AL) and subfoveal choroidal thickness (SFCT), was measured at baseline, after 60 and 120min of light exposure, and 30min post light offset. Three-way repeated measures ANOVA revealed that the effects of broadband and cyan light on AL (defocus × time × wavelength interaction, F (3,162) = 0.37, p = 0.777) and SFCT (F (3,162) = 0.35, p = 0.787) across all time points did not differ significantly between defocused and non-defocused eyes. However, exposure to cyan light significantly reduced axial elongation (mean difference in AL between cyan and broadband light: -0.011 ± 0.002mm; Holm-Sidak post hoc test, p = 0.001) and increased SFCT (mean difference: +0.009 ± 0.002mm; p < 0.001) at 120min, compared with eyes exposed to the same degree of hyperopic defocus under broadband light. In non-defocused eyes, cyan light resulted in a significant increase in SFCT compared to broadband light at 120min (mean difference, + 0.010 ± 0.001mm, p < 0.001), while no significant difference was observed in AL. No significant effect of refractive error was observed in either eye (p > 0.05). Short-term exposure to cyan light can inhibit AL elongation and choroidal thinning induced by hyperopic defocus, warranting further investigations into its long-term potential for myopia control.

To investigate the correlation between anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV), and IOP with white-to-white (WTW) corneal diameter in myopic eyes. This prospective study conducted at Qassim University, included 163 myopic eyes. Refraction was measured using an autorefractometer, axial length (AL) using IOL Master, and anterior chamber parameters, WTW corneal diameter, and central corneal thickness (CCT) using Pentacam. IOP was assessed with a non-contact tonometer. Correlation analysis was used to assess associations between measured parameters and WTW corneal diameter. For myopic eyes (spherical equivalent: -3.90 ± 1.75 D), mean ocular parameters were: ACD 3.18 ± 0.23mm, ACA 40.02 ± 3.75°, ACV 194.19 ± 18.75mm³, IOP 18.9 ± 2.90 mmHg, and WTW 12.06 ± 0.38mm. Bivariate analysis showed WTW corneal diameter positively correlated with ACD, ACV, ACA, AL, CCT, and IOP (P < 0.001). Multiple regression revealed age, myopia severity, AL, and CCT explained 43.6% of WTW variance, 32.7% in ACD, 26.7% in ACA, 23.0% in ACV, and 47.1% in IOP. Age was positively associated with WTW, ACA, and ACV (P < 0.001). Myopia severity was negatively associated with ACA and positively with ACV (P < 0.05). AL correlated positively with WTW, ACD, ACA, and IOP (P < 0.05), while CCT was significantly associated with most parameters (P < 0.05). Larger WTW corneal diameter predicts deeper anterior chamber and higher IOP in myopic eyes. High myopia shows posterior eye segment expansion with limited anterior growth, and an age-related changes indicate structural remodeling during ongoing myopia progression differs from classical physiological patterns. These findings underscore the importance of WTW corneal diameter as a significant predictor of ocular biometry and refractive development, particularly in young populations with progressing myopia.

The prevalence of myopia among adolescents in China has continued to rise in recent years, with an evident trend toward earlier onset and higher degrees of refractive error. This poses significant challenges to learning, daily life, and long-term visual health. Therefore, exploring effective non-pharmacological interventions for adolescent myopia is of practical importance. This study aims to evaluate the effectiveness of 3D visual training combined with physical exercise on visual function and myopia control in adolescents. A total of 188 adolescents with myopia who visited the Optometry Center of our hospital between November 2021 and November 2023 were enrolled and randomly assigned to an observation group (n = 94) or a control group (n = 94). The control group received standard interventions consisting of spectacle correction and eye exercises. The observation group underwent 3D visual training in combination with structured physical exercise. Outcomes assessed before and after intervention included mean uncorrected visual acuity (UCVA) of each eye, overall UCVA, refractive error, axial length, and spherical equivalent. Visual improvement after 6 months and the temporal progression of UCVA within the observation group were also analyzed. Baseline visual and refractive parameters showed no significant differences between the 2 groups (P > .05). After the intervention, both groups demonstrated improvements; however, the observation group exhibited significantly greater enhancement in UCVA, accompanied by lower refractive error, shorter axial length, and reduced spherical equivalent compared with the control group (P < .05). After 6 months, visual acuity improved in 64 participants (68.09%) in the observation group versus 39 participants (41.49%) in the control group, representing a statistically significant difference (P < .05). 3D visual training combined with physical exercise effectively improves uncorrected visual acuity, reduces refractive error, alleviates myopia progression, and promotes visual recovery in adolescents. This combined approach shows promise as a practical, noninvasive strategy for myopia prevention and management.

Purpose To quantitatively evaluate fundus tessellation density (FTD) in children with early-onset high myopia (eo-HM) using artificial intelligence (AI)–assisted image analysis and to explore its association with axial length (AL). Methods This cross-sectional study included children aged ≤6 years with eo-HM, defined as spherical equivalent (SE) ≤ −6.00 D and/or AL &amp;gt; 26.00 mm. Cycloplegic refraction, AL measurement, and ultra-widefield fundus photography were performed. A deep learning–based algorithm quantified FTD across concentric macular zones (1 mm, 3 mm, 6 mm) and anatomical sectors. Correlation and multivariate regression analyses were used to assess associations between FTD and AL. Results A total of 47 eyes from 31 children were analyzed. Mean SE was −9.35 ± 3.74 D and AL was 25.70 ± 1.50 mm. FTD declined from center to periphery ( p &amp;lt; 0.001), with greater values in nasal and inferior sectors at 6 mm. Overall FTD correlated with AL ( r = 0.46, p = 1.47 × 10 −3 ). In univariate regression, FTD significantly predicted AL ( β = 18.16, p = 1.76 × 10 −5 , R 2 = 0.352). Multivariable analysis showed that FTD in the 6 mm nasal and superonasal sectors remained independently associated with AL after adjusting for age and sex. Conclusion AI-assisted quantification of FTD provides a sensitive and objective measure of early retinal changes in eo-HM. Regional FTD, especially in nasal and perifoveal regions, is strongly associated with axial elongation and may serve as a useful biomarker for early diagnosis and monitoring of pediatric high myopia.

To quantify macular cone cell mosaic metrics in patients with varying degrees of myopia and explore its link to myopia severity using an adaptive optics (AO) fundus camera. A total of 76 age- and gender-matched patients with varying degrees of myopia (pre-myopia, low, moderate, and high) were recruited. Macular cone cell mosaic metrics (density, spacing, regularity, dispersion) were quantified via adaptive optics (AO) imaging, including correlations between AO-derived parameters and clinical indicators (spherical equivalent refraction, axial length) and predictive efficacy of AO metrics for myopia severity evaluated through receiver operating characteristic (ROC) curve analysis. As spherical equivalent refraction (SER) decreased, cone density (r = 0.65) and regularity (r = 0.38) significantly declined, while spacing (r = -0.65) and dispersion (r = -0.40) increased (all P < 0.001). Axial length (AL) was negatively correlated with density (r = -0.62) and regularity (r = -0.39), and positively correlated with spacing (r = 0.61) and dispersion (r = 0.38) (all P < 0.001). Predictive efficacy analysis based on AO-derived parameters revealed the highest AUROC value in the HM group (0.96), followed by Pre-M (0.86), LM (0.82), and MM (0.65) groups, indicating that AO metrics demonstrated superior early identification capability for HM severity. The AO fundus camera enables noninvasive evaluation of macular cone cell mosaic metrics, revealing strong correlations between density, regularity, spacing, dispersion, and myopia severity. These metrics demonstrate potential as biomarkers for evaluating myopic changes, with AO showing enhanced diagnostic efficacy in high myopia.

This study aimed to explore ocular and systemic factors associated with pathologic myopia in patients with high myopia and develop predictive models for differentiating between simple high myopia and pathologic myopia, particularly in its early stage. This cross-sectional study was conducted on 2767 patients with bilateral high myopia at baseline follow-up. Demographic, ocular biometric and clinical data were collected, including age, corrected distance visual acuity, axial length (AL), spherical equivalent (SE), myopic atrophy maculopathy (MAM) grading based on the International Meta-Analysis for Pathologic Myopia criteria and ocular and systemic comorbidities. Multimodal imaging techniques were employed to assess plus lesions and posterior staphyloma. Logistic regression was used to identify associated factors and develop predictive models. Among all patients, 1697 (61.33%) were classified as having pathologic myopia. Its prevalence increased with longer AL and more severe SE. Significant ocular comorbid associated factors included cataract, epiretinal membrane, foveoschisis, full-thickness macular hole, retinal detachment and strabismus, and hypertension was the only systemic associated factor identified. Predictive models for differentiating simple high myopia and pathologic myopia, MAM categories 1 and 2, achieved area under the curve values up to 0.978 and 0.964, respectively. This study underscores the high prevalence of pathologic myopia in a highly myopic population and identifies ocular and systemic associated factors for pathologic myopia. The developed predictive models provide valuable tools for distinguishing between simple high myopia and pathologic myopia, facilitating early diagnosis and management.

Axial and Choroidal Changes as Key Predictors of Myopia Control in Red-Light Therapy: Evidence from Machine Learning Models.