Gender-related differences in patients treated with intravitreal anti-vascular endothelial growth factor medication for diabetic macular oedema

Background: Diabetes prevalence is constantly rising, involving the eyes with damage including development of diabetic macular oedema. Since 2012, intravitreal anti-vascular endothelial growth factor medication is available for diabetic macular oedema treatment. Endocrinological studies have shown that fewer women are affected by diabetes. However, when affected, they exhibit more severe diabetic complications than men. We have investigated gender-related differences in diabetic macular oedema and outcome in an ophthalmological tertiary referral hospital. Methods: We included 88 patients (54 males and 34 females) with 112 eyes (68 male and 44 female) having clinically significant diabetic macular oedema, treated with anti-vascular endothelial growth factor medication. A 1 year follow-up was performed in all patients (visual acuity and optical coherence tomography). Previous retinal surgery was an exclusion criterion, as were other retinal pathologies. Results: The mean visual acuity and mean central retinal thickness at baseline were 0.53 logMAR (male 0.49 and female 0.595) and 469 mu m (male 452 mu m and female: 494 mu m), respectively. After 360 days, mean visual acuity changed by -0.07 (+/- 0.36) logMAR (male -0.11 and female +0.01) and mean central retinal thickness changed by -119 mu m (male -113 mu m and female -127 mu m). For visual acuity, a significant difference was noted at baseline (p = 0.02) and at 1 year (p < 0.001). Males received 5.6 injections and females received 5.68 injections in 1 year. Conclusion: Our study showed that female patients with diabetic macular oedema were diagnosed with and treated for diabetic macular oedema at a stage when visual acuity and optical coherence tomography were worse than those in their male counterparts. This gender difference could not be reduced, despite similar numbers of injections. Female diabetic patients should therefore be assessed early for ophthalmological pathologies.