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. 2017 Dec 21;7:18001. doi: 10.1038/s41598-017-18297-8

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© The Author(s) 2017

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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A schematic presentation of the suggested pathogenesis of the axial elongation and DPE position change. (A,D) The three dimensional eyeball appearance at baseline. (B,C) Symmetrical elongation primarily at the retro-equatorial region results in a tube-like enlargement of the globe, resulting the DPE location near the fovea. (E) Asymmetric growth in the retro-equatorial region of the globe results in a winding tube-like enlargement. (F) In this process, the DPE position is migrated towards the inferior hemisphere.