The pathological changes in clinically significant diabetic macular edema cause greater retinal thickening in men than in women. Therefore, male sex should be considered a potential risk factor for identifying individuals with the most severe ocular pathological changes related to diabetes, according to a new study. Understanding this excessive retinal thickening in men may ultimately help preserve vision.

Researchers investigated the effects of sex on retinal thickness in diabetes patients and tested whether men with clinically significant macular edema had even greater central macular thickness than expected. They found that diabetic men had thicker retinas than women—and those changes in male patients were exacerbated by clinically significant macular edema.

The study evaluated 2,047 predominantly underserved (i.e., two-thirds hadn’t had an eye exam in more than three years) adult patients with diabetes, 142 of whom had clinically significant macular edema. The team compared central macular thickness in men vs. women with and without clinically significant macular edema. Mean retinal thickness and variability of central macular layers were also compared between men and women.  

The researchers found that men without clinically significant macular edema had a 12μm greater average central macular thickness than women (245 ± 21.3μm and 233 ± 13.4μm, respectively). Men with clinically significant macular edema, on the other hand, had a 67μm greater average central macular thickness than women (383 ± 48.7μm and 316 ± 60.4μm, respectively), they noted. The team added that the outer nuclear layer thickness was more variable in men than in women.

 The researchers recommend clinicians follow a more intensive management and/or follow-up regimen for diabetic men with or without clinically significant macular edema compared with their female patients, which may help to reduce “the progression of neural damage or resolve the edema and preserve visual function in these subjects.”