Objective Defocus Curve from Pyramidal Wavefront Aberrometry: Supplementary Figures

This page hosts the supplementary figures of the study Constructing an Objective Defocus Curve from Pyramidal Wavefront Aberrometry: Mapping Objective-to-Subjective Through-Focus Response, published open access in the American Journal of Ophthalmology (online 29 October 2026). Read the full article.

Authors: Andrea Russo, Francesco Versaci, Vito Romano, Kieren Darcy, Valerio Bo, Ottavia Filini, Stephen Taylor, Alessandro Boldini, Jacopo Zilioli, Giacomo Savini.

The study shows that a defocus curve can be derived objectively from a single pyramidal wavefront aberrometry acquisition and mapped onto the subjective visual-acuity scale. It included 98 eyes of 63 patients from three centers (Brescia, Bristol and Genoa), with an external validation cohort of 19 eyes.

Supplemental Figure 1: model fit in the training set

Supplemental Figure 1: subjective visual acuity (logMAR) plotted against the second-moment objective metric (arcmin) in the training set, with the fitted rational model and its 95% confidence band

Supplemental Figure 1. Relationship between subjective visual acuity and the second-moment (SM) metric in the training set (56 eyes). The plot shows the association between the subjective visual acuity (VA) measurements and the corresponding SM values derived from the objective through-focus optical-quality profiles; the solid line represents the fitted rational mapping with its 95% confidence band. Each point represents an individual observation included in the training set.

The fitted rational model is y = a·SM + b + c/SM, with a = 0.0388 logMAR per arcminute, b = −0.0093 logMAR and c = −0.261 logMAR·arcmin.

Download the original figure (TIFF, 600 dpi)

Supplemental Figure 2: Bland-Altman analysis in the external validation cohort

Supplemental Figure 2: Bland-Altman plots of objective minus subjective depth of field in the external validation cohort, at the 0.20 and 0.30 logMAR levels

Supplemental Figure 2. Bland-Altman analysis of per-eye objective and subjective depth of field (DOFi) in the external validation cohort (19 eyes implanted with refractive extended-depth-of-focus intraocular lenses). (Top) Agreement between objective and subjective DOFi calculated at the 0.20 logMAR visual-acuity level. (Bottom) Agreement at the 0.30 logMAR level. For each eye, the objective and subjective DOFi were derived with the same definition: the range from 0.00 D to the negative defocus at which the acuity, normalized to its value at 0.00 D, falls to the 0.20 (or 0.30) logMAR level, located by linear interpolation. The solid line represents the mean bias and the dashed lines the 95% limits of agreement; differences are expressed as objective minus subjective DOFi.

In this cohort the mean difference between objective and subjective depth of field was −0.15 D (95% limits of agreement, −0.98 to +0.69 D) at the 0.20 logMAR level and +0.10 D (−0.40 to +0.60 D) at the 0.30 logMAR level.

Download the original figure (TIFF, 600 dpi)

How to cite

Russo A, Versaci F, Romano V, Darcy K, Bo V, Filini O, Taylor S, Boldini A, Zilioli J, Savini G. Constructing an Objective Defocus Curve from Pyramidal Wavefront Aberrometry: Mapping Objective-to-Subjective Through-Focus Response. American Journal of Ophthalmology. 2026. DOI: 10.1016/j.ajo.2026.10.018

About the study center

The study was coordinated by Dr. Andrea Russo at Gruppo Refrattivo Italiano (Centro Oculistico Bresciano), a refractive and cataract surgery center with clinics in Brescia and Bergamo, Italy. It was carried out with the research department of CSO (Florence), the University of Brescia, Vision Care Clinic (Bristol), Casa della Salute (Genoa) and the IRCCS G.B. Bietti Foundation (Rome).

More: all publications of the group, summary of the study in Italian, contacts.

Last updated: 14 November 2026.