Age-specific sex distributions of posterior-segment eye diseases

Abstract

Purpose : To determine the sex distributions among the diagnoses of the most prevalent posterior-segment eye diseases.

Methods : From the American Academy of Ophthalmology' s IRIS^® Registry (Intelligent Research in Sight), a database of over 60 million ophthalmic patients, all patients with diagnostic reports in 2017 and ICD-10 diagnoses of dry (ICD code: H35.31) and wet (H35.31) age-related macular degeneration (AMD), diabetic retinopathy (DR) due to type 1 (E10.3) and type 2 (E11.3) diabetes mellitus (DM), and open angle (H40.1) and angle closure (H40.2) glaucoma were selected if their age fell within one of the following bins: ±2 years around 50, 60, 70, and 80 years. As a baseline, the male/female ratio for the entire set of IRIS patients within these age bins in 2017 were calculated. For all age bins of each of the posterior-segment diseases, the sex ratio was compared to the respective baseline sex ratio by a binomial test to determine relative differences with respect to the general population of ophthalmic patients.

Results : 8.26 million patients were selected over all age bins for the baseline sex ratios (Table 1) and 821,743/597,510/714,628 patients for AMD/DR/glaucoma, respectively. Tables 2 to 4 show the respective sex ratios with differences marked in blue/red if there were significantly (P<0.05) more males/females diagnosed with the respective disease compared to baseline within the respective age bin. Over all posterior-segment diseases, there was a trend of an increasing frequency of females with increasing age. Compared to baseline, dry AMD was significantly more frequently diagnosed in females from age 60 on. Wet AMD was more frequently diagnosed in males before age 80. DR and open angle glaucoma were consistently more frequently diagnosed in males over all age bins, whereas angle closure glaucoma was significantly more frequently diagnosed in females from age 60 on. Over all age bins, wet AMD was more frequently diagnosed in males compared to dry AMD, and angle closure glaucoma more frequently in females compared to open angle glaucoma (all P<0.05).

Conclusions : Sex ratios of posterior-segment disease diagnoses vary with age within each disease as well as over subtypes of diseases, with higher male frequencies for open angle compared to angle closure glaucoma and for wet compared to dry AMD. Strongest male preferences were found for DR (up to 16% more diagnoses for males compared to baseline).

This is a 2020 ARVO Annual Meeting abstract.