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Purpose <p>To investigate five-year changes in fundus mosaic density (FTD) and their associations with refractive parameters in high and extreme myopia using deep learning.</p> Method <p>A total of 102 eyes from 102 individuals with high myopia (spherical equivalent [SE]: -9.55 ± 2.53 D) were enrolled. Participants were divided into a high myopia group (-10.0 D &lt; SE ≤ -6.0 D, 54 eyes) and an extreme myopia group (SE ≤ -10.0 D, 48 eyes). All patients completed a five-year follow-up. Ultrawide-field fundus images were processed by artificial intelligence software to quantify FTD (whole fundus, macular), cup-to-disc ratio, and parapapillary atrophy (PPA). Statistical analysis was performed using R software, and the significance level was set at <i>p</i> &lt; 0.05.</p> Results <p>FTD increased significantly across all regions in both groups. The extreme myopia group also exhibited a marked enlargement of PPA. In the high myopia group, SE was negatively correlated with changes in macular (<i>r</i> = -0.331, <i>p</i> = 0.014) and peripapillary FTD (<i>r</i> = -0.285, <i>p</i> = 0.037). Changes in axial length (AL) were significantly positively correlated with changes in pan-fundus FTD (<i>r</i> = 0.274, <i>p</i> = 0.045), macular FTD (<i>r</i> = 0.508, <i>p</i> &lt; 0.001), peripapillary FTD (<i>r</i> = 0.339, <i>p</i> = 0.012), and PPA area (<i>r</i> = 0.441, <i>p</i> = 0.001). However, in the extreme myopia group (0.23 ± 0.28&#xa0;mm) with faster axial growth, these refractive parameters and changes in the axial axis were not significantly correlated with FTD changes.</p> Conclusion <p>Fundus alterations in high myopia continue to progress during adulthood and are strongly associated with axial elongation at the high myopia stage. FTD provides a robust quantitative biomarker for monitoring these structural changes.</p>

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Fundus tessellation density as a quantitative marker of myopia progression: a five-year longitudinal deep learning study

  • 期刊论文

  • 发表日期：

    2026年3月26日

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  • Weijung Ten,
  • Zhiwei Mao,
  • I-Chun Lin,
  • Yadi Lei,
  • Xi Wang,
  • Xingtao Zhou,
  • Xun Chen,
  • Xiaoying Wang

摘要

Purpose

To investigate five-year changes in fundus mosaic density (FTD) and their associations with refractive parameters in high and extreme myopia using deep learning.

Method

A total of 102 eyes from 102 individuals with high myopia (spherical equivalent [SE]: -9.55 ± 2.53 D) were enrolled. Participants were divided into a high myopia group (-10.0 D < SE ≤ -6.0 D, 54 eyes) and an extreme myopia group (SE ≤ -10.0 D, 48 eyes). All patients completed a five-year follow-up. Ultrawide-field fundus images were processed by artificial intelligence software to quantify FTD (whole fundus, macular), cup-to-disc ratio, and parapapillary atrophy (PPA). Statistical analysis was performed using R software, and the significance level was set at p < 0.05.

Results

FTD increased significantly across all regions in both groups. The extreme myopia group also exhibited a marked enlargement of PPA. In the high myopia group, SE was negatively correlated with changes in macular (r = -0.331, p = 0.014) and peripapillary FTD (r = -0.285, p = 0.037). Changes in axial length (AL) were significantly positively correlated with changes in pan-fundus FTD (r = 0.274, p = 0.045), macular FTD (r = 0.508, p < 0.001), peripapillary FTD (r = 0.339, p = 0.012), and PPA area (r = 0.441, p = 0.001). However, in the extreme myopia group (0.23 ± 0.28 mm) with faster axial growth, these refractive parameters and changes in the axial axis were not significantly correlated with FTD changes.

Conclusion

Fundus alterations in high myopia continue to progress during adulthood and are strongly associated with axial elongation at the high myopia stage. FTD provides a robust quantitative biomarker for monitoring these structural changes.