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Objective To use optical coherence tomography angiography (OCTA) to compare macular blood flow density, subfoveal choroidal thickness (SFCT) and outer retina thickness (ORT) in non-proliferative diabetic retinopathy (NPDR) patients with different axial length (AL). Methods Total 42 patients with NPDR with different eye axis were divided into three groups: group A: 22 mm≤AL<24 mm; group B: 24 mm≤AL<26 mm; group C: AL≥26 mm. Superficial capillary plexus (SCP) in the macular area, vascular length density (VLD) and vascular perfusion density (VPD) in the foveal region, the parafoveal region, the perifoveal region and whole macular region were analyzed. The correlations among axial length, macular microvascular density, SFCT and outer retinal thickness (ORT) were analyzed. Results Compared with group A and B, VLD and VPD in group C were significantly lower except the foveal region, and VLD and VPD were negatively correlated with AL. The difference in SFCT among group A, B and C was significant, and SFCT was negatively correlated with AL. Compared with group A, parafoveal ORT in group C was significantly lower than that in group A, and parafoveal ORT was negatively correlated with AL. Conclusion In NPDR patients with different AL, macular microvascular density, SFCT, and parafoveal ORT decreased with the increase of AL.