Bruch membrane is divided into 5 layers between the pigment epithelium and the choroid, which regulates metabolism between choroid and retinal pigment epithelium to maintaining normal visual function. Its morphology and composition change with age, resulting in the decline of its function. Also, Bruch membrane plays an important role in the occurrence and progress of myopia, especially in high myopia. Bruch membrane opening, as the inner layer of the optic nerve head layers, is shifted in the temporal direction in the process of axial elongation. The lack of Bruch membrane at the temporal disc side is the histological equivalent of the parapapillary gamma zone. Gamma zone enlarges and the prevalence of Bruch membrane defects in the macular region increases with longer axial length. (Int Rev Ophthalmol, 2021, 45: 221-225)