Sex differences in risk factors for retinopathy in non‐diabetic men and women: The Tromsø Eye Study

. Purpose:  To determine the prevalence and risk factors for retinopathy in a nondiabetic population. Methods:  The study population included 5869 participants without diabetes aged 38–87 years from the Tromsø Eye Study, a substudy of the population‐based Tromsø Study in Norway. Retinal images from both eyes were graded for retinopathy. We collected data on risk factors from self‐report questionnaires, clinical examinations, laboratory measurements and case note reviews. The cross‐sectional relationship between potential risk factors and retinopathy was assessed using logistic regression analysis. Results:  The overall prevalence of retinopathy was 14.8%. Men had a higher prevalence of retinopathy compared with women (15.9% versus 14.0%, p = 0.04). In men, retinopathy was associated with hypertension (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.24–2.04) and HbA1c (OR per %, 1.41; 95% CI, 1.01–1.96). In women, retinopathy was associated with age (OR per 10 years, 1.32; 95% CI, 1.14–1.52), log‐transformed urinary albumin excretion (OR per log unit, 1.46; 95% CI, 1.14–1.87) and hypertension (OR, 1.36; 95% CI, 1.08–1.71). In women, retinopathy was associated with very low levels of urinary albumin excretion (urinary albumin/creatinine ratio >0.43 mg/mmol). Conclusion:  This study confirms results from previous studies on the strong association between blood pressure and retinopathy. A novel finding is the sex differences in risk factors for retinopathy, suggesting a sex difference in the pathogenesis leading to retinopathy.