To evaluate the effects of age on the distributional variability of peripapillary retinal nerve fiber layer (RFNL) thickness measured by optical coherence tomography (OCT) in myopia.

Only the right eye of 64 myopic patients with long axial length (≥24.5 mm) was included in the present study. The patients were divided into 2 age groups, 20 to 39 years of age and 40 to 59 years of age. Eventually, 42 subjects were selected and matched based on the difference of axial length not exceeding 0.5 mm between subjects in each group. The RFNL thickness was measured using Stratus OCT and average thickness, angular locations of double humps, and false-positive rate were compared.

In both groups, the distribution of RNFL thickness in a double hump pattern was observed, which had a deviation to the temporal side only in the younger myopic eye group, but not in the middle-aged group. The middle-aged group had significantly thinner RNFL in 1, 7, and 8 clock-hour sectors compared to the younger myopic eyes ( p ≤ 0.02). Probability of abnormal OCT parameters at the 5% level of the 2 groups with the built-in RNFL normative database was not significantly different.

The variability of RFNL thickness distribution related to axial length was less observed in the middle-aged group than the younger-aged group. These results should be considered in glaucoma diagnosis when using OCT.