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Real-world Associations Between GLP-1 Receptor Agonist Use and Diabetic Retinopathy Accounting for Longitudinal
Ramin Talebi1,2, Blake H Fortes1, Fei Yu1,3
1Department of Ophthalmology, Stein and Doheny Eye Institutes, David Geffen School of Medicine, University of California, Los Angeles, CA.
Retina (Philadelphia, Pa.)
|May 7, 2025
Summary
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) reduce the risk of diabetic retinopathy (DR) and diabetic macular edema (DME). GLP-1 RA use is associated with fewer instances of treatment-requiring DR/DME in type 2 diabetes patients.
Area of Science:
- Endocrinology
- Ophthalmology
- Pharmacology
Background:
- Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are used for type 2 diabetes management.
- Conflicting evidence exists regarding GLP-1 RAs' impact on diabetic retinopathy (DR).
Purpose of the Study:
- To investigate the association between GLP-1 RA use and the risk of developing diabetic retinopathy (DR), diabetic macular edema (DME), and treatment-requiring DR/DME.
- To clarify the role of GLP-1 RAs in the progression of diabetes-related eye conditions.
Main Methods:
- Longitudinal, retrospective cohort study of type 2 diabetes mellitus patients over 10 years.
- Survival analyses and Cox proportional hazards models were used.
- Adjustments were made for multiple confounding factors including age, comorbidities, and glycemic control.
Main Results:
- GLP-1 RA use was associated with a significantly decreased risk of DR (HR: 0.31, 95% CI: 0.26 - 0.37).
- A reduced risk of DME (HR: 0.40, 95% CI: 0.27 - 0.59) and treatment-requiring DR/DME (HR: 0.18, 95% CI: 0.08 - 0.40) was observed in GLP-1 RA users.
- All associations were statistically significant (p<0.001).
Conclusions:
- GLP-1 receptor agonist users demonstrated a reduced risk of developing DR, DME, and the need for treatment for these conditions.
- GLP-1 RAs appear to be protective against poor visual outcomes in diabetic patients.
- Further research is warranted to ascertain the protective effects of GLP-1 RAs when initiated after DR development.
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