A retrospective review of 114 eyes of 114 highly myopic patients (spherical equivalent refractive error [SERE] exceeding −6 diopters [D] or AL exceeding 26 mm) was done. Each subject underwent a complete ophthalmic examination and SS-OCT (Topcon, Tokyo, Japan) at Osaka University Hospital, Osaka, Japan, between December 2010 and April 2013. The subjects were consecutive patients who were referred to the Department of Ophthalmology, Osaka University Hospital, Osaka, Japan, and provided written informed consent to participate in this study. Inclusion criteria were the absence of ophthalmic or systemic symptoms, macular abnormalities causing visual impairment found on nonmydriatic fundus photographs and OCT images, fundus visualization obscured by cataract, history of intraocular surgery except for cataract surgery, glaucomatous disc cupping reviewed by a glaucoma specialist (SU), general good health, and availability of good-quality SS-OCT images. If both eyes met the study criteria, one eye was chosen randomly. Five eyes with extensive PPA in which the RPE line could not be traced on OCT images and four eyes with a glaucomatous optic appearance were excluded. Ultimately, 114 eyes of 114 subjects were included. The institutional review board/ethics committee of the Osaka University Hospital approved the study, which was conducted according to the tenets of the Declaration of Helsinki.