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Laura Phan, Timothy McCulley; Age Related Gender Differences in the Occurrence of Acquired Nasolacrimal Duct Obstruction in Saudi Arabia. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5347.
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In the United States, acquired idiopathic nasolacrimal duct obstruction (NLDO) occurs with a 1:2 male to female ratio. The age related incidence in males has been reported to parallel that of females, with a peek occurrence rate in middle age. In this study we assess the male to female occurrence ratio as a function of age amongst patients with acquired nasolacrimal duct obstruction in Saudi Arabia.
The medical record database at King Khaled Eye Specialist Hospital was used to identify sixty six patients (19 males, 47 females, mean age 45.7, range 15 to 87 years of age) who consecutively underwent dacryocystorhinostomy (DCR) for acquired nasolacrimal duct obstruction between January 1, 2011 and April 31, 2012. Records were reviewed for age, gender and etiology.
Male to female ratios are 1:2.2 (5 males, 11 women) in patients 30 years of age and younger, 1:3.5 (8 males, 28 females) in patients 31 to 60 years of age, and 1:1.3 (6 males, 8 women) in patients over 60 years of age. Discordance is most notable in the 5th decade when the male to female ratio is 1:16 (1 male, 16 females). This difference is statistically different from other decades (p=0.015, Chi-square for goodness of fit).
In Saudi Arabia, the overall male to female ratio of patients with NLDO is 2.4. This ratio does not remain constant, with the ratio being closer to one in much younger and older patients. Occurrences in men are more uniformly distributed as compared to women, who have a disproportionate number of occurrences in middle age. This suggests that pathophysiology, in at least a proportion of cases, differs in men and women. Also, although a direct comparison is not made, this differs from previously described cohorts from the United States. Whether these differences represent genetic, environmental or other factors, remain to be determined.
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