Sex differences in the relationship between axial length and dry eye in elderly patients

PURPOSE: The aim of this study was to explore the association between myopia and dry eye (DE)-related ocular parameters. METHODS: We recruited a total of 460 patients (mean age, 73.6 years; 40.2% men) and performed DE-related, axial length (AL) and retinal examinations. Statistical analysis revealed a significant sex difference in AL, strip meniscometry value, corneal staining score, corneal endothelial cell density, ganglion cell complex (GCC) thickness, and full macular thickness. AL was strongly age- and sex-dependent, so subsequent analyses were stratified by sex. RESULTS: Among DE-related parameters, strip meniscometry value (ß = −0.167, p = 0.033) and corneal endothelial cell density (ß = −0.139, p = 0.023) were correlated with AL in women but not in men. Regarding retinal parameters, GCC thickness and full macular thickness were correlated with AL in women but not in men. CONCLUSION: The current results suggest a relationship between tear production and AL in elderly women and support the hypothesis that there may be a common upstream factor including the parasympathetic nervous system in the association between tear production and AL or DE and myopia.