Myopic axial elongation is associated with various non-pathological changes. These include a decrease in photoreceptor cell and retinal pigment epithelium (RPE) cell density and retinal layer thickness, mainly in the retro-equatorial to equatorial regions; choroidal and scleral thinning pronounced at the posterior pole and least marked at the ora serrata; and a shift in Bruch's membrane opening (BMO) occurring in moderately myopic eyes and typically in the temporal/inferior direction. The BMO shift leads to an overhang of Bruch's membrane (BM) into the nasal intrapapillary compartment and BM absence in the temporal region (i.e., parapapillary gamma zone), optic disc ovalization due to shortening of the ophthalmoscopically visible horizontal disc diameter, fovea–optic disc distance elongation, reduction in angle kappa, and straightening/stretching of the papillomacular retinal blood vessels and retinal nerve fibers. Highly myopic eyes additionally show an enlargement of all layers of the optic nerve canal, elongation and thinning of the lamina cribrosa, peripapillary scleral flange (i.e., parapapillary delta zone) and peripapillary choroidal border tissue, and development of circular parapapillary beta, gamma, and delta zone. Pathological features of high myopia include development of macular linear RPE defects (lacquer cracks), which widen to round RPE defects (patchy atrophies) with central BM defects, macular neovascularization, myopic macular retinoschisis, and glaucomatous/glaucoma-like and non-glaucomatous optic neuropathy. BM thickness is unrelated to axial length. Including the change in eye shape from a sphere in emmetropia to a prolate (rotational) ellipsoid in myopia, the features may be explained by a primary BM enlargement in the retro-equatorial/equatorial region leading to axial elongation.

近视眼轴伸长与各种非病理性变化有关。这些包括感光细胞和视网膜色素上皮（RPE）细胞密度和视网膜层厚度的减少，主要发生在赤道后至赤道区域；脉络膜和巩膜变薄在后极明显，锯齿缘最不明显；布鲁赫膜开口（BMO）的变化发生在中度近视眼中，通常发生在颞/下方向。BMO 移位导致 Bruch 膜 (BM) 突出到鼻乳头内室中，并且颞区（即乳头旁伽玛区）中 BM 缺失，由于检眼镜可见水平视盘直径缩短而导致视盘椭圆化，中央凹-视神经椎间盘距离延长、卡帕角减小以及乳头黄斑视网膜血管和视网膜神经纤维的拉直/拉伸。高度近视眼还表现出视神经管各层的扩大、筛板、视乳头周围巩膜凸缘（即视乳头旁三角区）和视乳头周围脉络膜边缘组织的伸长和变薄，以及圆形视乳头β、γ和视盘周围组织的发育。三角洲地带。高度近视的病理特征包括黄斑线状 RPE 缺损（漆裂）发展为圆形 RPE 缺损（斑片状萎缩）并伴有中央 BM 缺损、黄斑新生血管、近视性黄斑视网膜劈裂以及青光眼/青光眼样和非青光眼视神经神经病。BM厚度与眼轴长度无关。包括眼睛形状从正视眼的球体到近视眼的长长（旋转）椭球体的变化，这些特征可以通过赤道后/赤道区域的原发性BM增大导致眼轴伸长来解释。