This study found that both male sex and axial length may influence DR risk through different mechanisms. Photo: Jay Haynie, OD. Click image to enlarge.

Nearly a third of people with diabetes have diabetic retinopathy (DR), though it’s not clear which factors play a role in patient susceptibility to DR development. Upon conducting a study that investigated the potential risk factors, researchers recently concluded that longer axial length appears to be associated with DR risk, along with male sex, though in this cohort sex didn’t impact the relationship between axial length and DR risk.

The cross-sectional observational study analyzed records collected over a three-year period. A total of 1,843 men and women with types 1 or 2 diabetes were included. Based on the data, male sex was a risk factor for DR, with an odds ratio of 1.5. After adjusting for systemic risk factors, the researchers also found that shorter axial length in either men or women was associated with a higher DR prevalence (odds ratios: 0.77, men; 0.83, women).

The researchers pointed out the following observation: “In the subset of patients with asymmetric DR, the percentage of patients whose shorter eye had a higher stage of DR was not significantly different between men and women.” They concluded that while the data showed that male sex was an independent risk factor for DR, “the protective effect of axial length on DR did not manifest differently according to sex.”

The lack of interaction between sex and axial length could suggest that the two may each influence DR risk through separate mechanisms. Based on this observation, the study authors highlighted the need for further research on the topic.

Qian J, Haq Z, Yang D, et al. Male sex increases the risk of diabetic retinopathy in an urban safety-net hospital population without impacting the relationship between axial length and retinopathy. Sci Rep. June 13, 2022. [Epub ahead of print].