Objective To evaluate the changes in the distribution of peripapillary and macular retinal nerve fiber layer (RNFL) thickness distribution in a group of subjects with high myopia.Methods It was a prospective case control study.Thirty-three eyes of 33 patients with high myopia (33 eyes) and 35 eyes of 35 control subjects (35 eyes) were recruited in jinhua Municipal Central Hospital from March 2011 to August 2011.Macular RNFL thickness was measured in the macular fovea and 750 μm away from the center of the fovea in the superior,inferior,temporal and nasal directions using optical coherence tomograhy (OCT).Peripapillary RNFL thickness was measured using the OCT Fast RNFL 3.4 mr scan protocol.An independent samples t test was used to compare the difference between the two groups.Results The thickness of macular RNFL was significantly thinner in patients with high myopia than that in the control subjects.Although there was no significant difference in peripapillary RNFL thickness between the patients and the controls,tthere was a trend to be thinner in the patients with high myopia in each the 12 o'clock hour direction.Conclusion It is significant that the thickness of the macular RNFL is thinner in patients with high myopia than that in control subjects.Particular caution is needed to prevent false positive errors when the RNFL appears to be below the normal limit in glaucoma patients complicated by high myopia.OCT offers a good method to evaluate the thickness of RNFL and to be used in follow-ups.