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Objectives <p>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.</p> Methods <p>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.</p> Results <p>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 <i>P</i> &lt; 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 <i>P</i> &lt; 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.</p> Conclusions <p>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.</p>

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Macular cone cell mosaic metrics in myopia: severity evaluation and diagnostic efficiency using adaptive optics fundus camera

  • 期刊论文

  • 发表日期：

    2026年1月8日

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  • Ke-Yu Liu,
  • Ju-Xian Liu,
  • Zhou-Yu Li,
  • Yu Yue,
  • Ren-Yue Xiao,
  • Chen Zeng,
  • Qi Li,
  • Shu-Lin Liu,
  • Wen-Juan Wan,
  • Wen-Li Deng,
  • Yan-Lai Zhang

摘要

Objectives

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.

Methods

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.

Results

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.

Conclusions

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.