The study by Xiong and colleagues represents an important and timely contribution to our understanding of pathologic myopia, providing rare longitudinal evidence on the prognostic value of 3-dimensional (3D) eye shape assessed by magnetic resonance imaging (MRI). While previous studies have demonstrated the utility of 3D-MRI in visualizing global ocular deformation, most studies have been cross-sectional. The present work is notable for its 15-year follow-up, offering a unique opportunity to link baseline morphologic features with long-term structural and functional outcomes.