Male–Female Differences in Diabetic Retinopathy?

Abstract

The purpose of this paper is to review male–female differences in the incidence and prevalence of diabetes and diabetic retinopathy. These differences will be established primarily through results from our present research and a review of related literature. Previously, we have demonstrated that neuroretinal dysfunction can be used to predict the location of future retinopathy up to three years before it is manifest. Our current research suggests that, for type 2 diabetes, the normal differences in neuroretinal function between nondiabetic males and females under 50 years of age are altered in patients with type 2 diabetes. Furthermore, local neuroretinal function in type 2 diabetes is more abnormal in adult males compared with adult females. The literature also suggests that there are male–female differences in the occurrence of diabetes. In adolescence, the incidence of type 1 diabetes is greater in males, whereas in type 2 diabetes, the incidence is greater in females. This excess of females in type 2 diabetes shifts to a more equal incidence between the two sexes in adults. In addition, advanced retinopathy in type 1 diabetes appears to be more common in males, and the presence and severity of diabetic retinopathy at the time of diagnosis in type 2 diabetes appears to be more associated with male sex. Although the reasons for male–female differences identified in this review are unknown, sex appears to be a significant factor in certain aspects of diabetes incidence and diabetic retinopathy.

• Diabetes
• diabetic retinopathy
• electroretinogram
• gender
• multifocal ERG
• neuroretinal function
• sex differences

Acknowledgments

The authors are grateful to Kavita Dhamdhere, MD, PhD, Brian Wolff, OD, Wendy Harrison, OD, PhD, Kevin Bronson-Castain, PhD, RN, and Jason Ng, OD, PhD, for collecting the neuroretinal (mfERG) data presented in this review; Shirin Barez, MD, for grading the fundus images; and Marilyn Schneck, PhD, for helping to edit the manuscript.

Declaration of interest

The authors have no conflicts of interest with the subject matter presented in this manuscript. Research on neuroretinal function presented in this paper was funded by two grants: NIH EY02271 (AJA) and JDRF 8-2008-0823 (MAB).