{
  "abstract": "Purpose\n\nTo characterize layer-specific, potentially non-linear associations between axial length (AL) and macular ganglion cell-inner plexiform layer (GCIPL), peripapillary retinal nerve fiber layer (RNFL), outer-retinal, and subfoveal choroidal thickness (SFCT) in a nationally representative sample of Korean adults.Methods\n\nCross-sectional analysis of the Korea National Health and Nutrition Examination Survey 2017-2021. Right eyes of adults ≥19 years with AL and optical coherence tomography measurements were included; eyes with major retinal or optic-nerve disease or implausible measurements were excluded. Survey-weighted spline regression tested non-linearity by a design-based nested comparison adjusted for age and sex. Ocular magnification, refractive error, and intraocular pressure were addressed in sensitivity analyses.Results\n\nAmong 9867 participants (mean age 42.6 years; AL 24.4 mm), AL was associated with all four layers (all P < 0.001). GCIPL was nonlinear (P < 0.001), steepening at longer AL, and remained so after adjustment for magnification and refractive error. The RNFL association was not robust to magnification correction: a keratometry-based correction moved the slope from -2.2 to +0.2 µm/mm (P = 0.48), and an axial-length-only factor reversed it, indicating over-correction. Outer retina was essentially preserved (≈-0.4 µm/mm), whereas SFCT showed the largest, approximately linear association (≈-31.8 µm/mm). Excluding ocular hypertension did not change the findings.Conclusions\n\nThe apparent RNFL thinning with longer AL was largely attributable to scan-circle magnification rather than tissue thinning. The other layers differed in form: a non-linear GCIPL association and a large, approximately linear choroidal reduction, with outer-retinal preservation. Interpretation should account for AL, magnification, and functional form across layers.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Ophthalmology, Hangil Eye Hospital, Incheon, Republic of Korea.",
    "Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Min-Ji Kim"
    },
    {
      "affs": [
        1
      ],
      "name": "Dah Hyun Ryu"
    },
    {
      "affs": [
        1
      ],
      "name": "Mingui Kong"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dqh1vsk6c03wk.bib",
  "cited_by": 0,
  "doi": "10.1167/iovs.67.12.26",
  "fulltext_url": "https://europepmc.org/articles/PMC13676223",
  "id": "dqh1vsk6c03wk",
  "issns": [
    "0146-0404",
    "1552-5783"
  ],
  "landing_url": "https://europepmc.org/article/MED/42872946",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2731|Glaucoma and retinal disorders"
    ]
  ],
  "openalex": "W7221752129",
  "pdf_url": "https://europepmc.org/articles/PMC13676223?pdf=render",
  "pmcid": "PMC13676223",
  "pmid": "42872946",
  "published": "2026-10-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/dqh1vsk6c03wk.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:00Z",
      "native_id": "MED:42872946",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42872946"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2731|Glaucoma and retinal disorders",
      "subfield": "general"
    }
  ],
  "title": "Layer-Specific Associations of Axial Length With Retinal and Choroidal Thickness: A Nationally Representative Population-Based Study.",
  "title_text": "Layer-Specific Associations of Axial Length With Retinal and Choroidal Thickness: A Nationally Representative Population-Based Study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:00Z",
  "url": "https://research.draconitic.com/paper/dqh1vsk6c03wk",
  "venue": "Investigative ophthalmology & visual science",
  "versions": []
}