This article describes the first systematic investigation of how the efficiency roll-off in organic light-emitting diodes (OLEDs) is influenced by the position and orientation of the emitter molecules within the OLED cavity. The efficiency roll-off is investigated for two OLED stacks containing either the phosphorescent emitter Ir(MDQ)2(acac) or Ir(ppy)3 by varying the distance between emitter and metal cathode; a strong influence of emitter position and orientation on roll-off is observed. The measurements are modeled by triplet-triplet-annihilation (TTA) theory yielding the critical current density and the TTA rate constant. It is found that Ir(MDQ)2(acac) shows the lowest roll-off when the emitter is located in the first optical maximum of the electromagnetic field, whereas the roll-off of the Ir(ppy)3 stack is lowest when the emitter is positioned closer to the metal cathode. Measurement and modeling of time-resolved electroluminescence show that the different roll-off behavior is due to the different orientation and the corresponding change of the decay rate of the emissive dipoles of Ir(MDQ)2(acac) and Ir(ppy)3. Finally, design principles are developed for optimal high-brightness performance by modeling the roll-off as a function of emitter-cathode distance, emissive dipole orientation, and radiative efficiency.