Pre-Miopia: il ruolo della lunghezza assiale e del rapporto AL/CC nella valutazione del rischio miopico

Myopia represents an increasing challenge for global public health, with a projected prevalence of 50% by 2050. In recent years, clinical attention has shifted toward “pre-myopia,” a critical refractive condition for the early identification of individuals at risk of progression to high myopia and severe ocular complications. The present work proposes an integrated assessment model based on the oculomic profile, overcoming the limitations of refractive error evaluation alone.Through an analysis of recent literature, the study examines the role of hyperopic reserve and the importance of ocular biometry. In clinical settings where cycloplegia cannot be performed, fogging techniques and accurate retinoscopy remain essential, although they are subject to limitations in accuracy. The proposed model highlights how axial length (AL), interpreted through percentile growth curves, and the ratio between axial length and corneal curvature (AL/CR) represent the most reliable biomarkers. In particular, an AL/CR value approaching 2.96 identifies a critical transitional phase, whereas values exceeding the 3.0 threshold indicate the structural onset of myopia. The integration of these objective parameters allows for precise and dynamic risk stratification.In conclusion, the adoption of evidence-based strategies during the pre-myopic phase enables the implementation of timely preventive and management interventions, which are essential for mitigating the impact of myopic disease in pediatric populations.