Optic neuropathy in high myopia

Myopia, particularly high myopia, has become a significant global public health issue due to its increasing prevalence. High myopia is associated with various ocular complications, including early-onset cataracts, glaucoma, retinal detachment, and myopic maculopathy, yet optic nerve damage is often overlooked. This article reviews the morphological changes in the optic disc, peripapillary region, and retinal layers, along with the relevant functional defects. Additionally, recent advancements in artificial intelligence (AI)-related research in this field are summarized. The article also highlights the need for developing a standardized grading and classification system for high-myopic optic neuropathy, supported by large-scale, high-quality longitudinal cohort studies to explore the relationships between myopic optic neuropathy and other complications, experimental research to uncover the underlying mechanisms of optic nerve damage, and the integration of AI - all of which are essential for improving diagnostic accuracy, monitoring, and treatment strategies for high myopia patients at risk of progressive vision loss.