Spherical Equivalent Refraction versus Axial Length for Monitoring Childhood Myopia and Estimating Disease Risk: A Systematic Review and Meta-Analysis

The authors aimed to evaluate whether spherical equivalent refraction (SER) or axial length (AL) is a more effective measure for monitoring childhood myopia progression and predicting related adult pathologies. Their systematic review and meta-analysis of 70 studies revealed that while AL thresholds identify a small group at high retinal risk, SER provides a more comprehensive assessment of cataract and primary open-angle glaucoma risks across the broader myopic population. Consequently, they recommend using SER as the primary metric for monitoring childhood myopia, with AL reserved for cases of significant axial elongation.