To assess the impact of axial length on the age-related peripapillary retinal nerve fiber layer (RNFL) thinning. This cross-sectional observational comparative case series included 172 eyes from 172 healthy Korean subjects. Peripapillary RNFL thickness was measured using an Optic Disc Cube 200 × 200 scan of spectral domain Cirrus HD OCT and the axial length was measured using IOL Master Advanced Technology. In age groups based on decade, the normal ranges of peripapillary RNFL thickness for average, quadrant, and clock-hour sectors were determined with 95% confidence intervals. After dividing the eyes into two groups according to axial length (cut-off, 24.50 mm), the degrees of age-related RNFL thinning were compared. Among the eyes included in the study, 53 (30.81%) were considered to be long eyes (axial length, 25.04 ± 0.48 μm) and 119 (69.19%) were short-to-normal length eyes (axial length, 23.57 ± 0.60 μm). The decrease in average RNFL thickness with age was less in long eyes (negative slope, -0.12 μm/yr) than in short-to-normal length eyes (negative slope, -0.32 μm/yr) (p < 0.001). Age-related thinning of peripapillary RNFL thickness is attenuated in long eyes compared to short-to-normal length eyes.
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