Risk of Age-Related Ocular Diseases in Non-Diabetic Adults With Obesity Using Glucagon-Like Peptide 1 Receptor...

To assess whether glucagon-like peptide-1 receptor agonists (GLP-1RAs) are associated with a lower incidence of age-related ocular diseases in non-diabetic older adults with overweight or obesity.

We conducted a retrospective, propensity score-matched cohort study using the TriNetX global research network. Non-diabetic, overweight or obese adults aged ≥ 60 years with an ophthalmic disease-naïve baseline were enrolled. Patients receiving liraglutide or semaglutide were matched 1:1 with users of alternative weight-loss medications (bupropion-naltrexone, phentermine-topiramate, setmelanotide or orlistat). Outcomes included up to 5-year risks of incident cataract, age-related macular degeneration (AMD), ocular hypertension, primary open-angle glaucoma (POAG) and dry eye syndrome (DES).

After matching, 68 536 patients were included (34 268 per group). GLP-1RAs use was significantly associated with a lower 5-year risk of cataract (RR: 0.45; 95% CI, 0.40-0.50), AMD (RR: 0.33; 95% CI, 0.23-0.48), ocular hypertension (RR: 0.56; 95% CI, 0.34-0.91), POAG (RR: 0.50; 95% CI, 0.32-0.78) and DES (RR: 0.36; 95% CI, 0.31-0.42). Sensitivity analyses consistently demonstrated a lower risk across cataract subtypes, including nuclear (RR: 0.42; 95% CI, 0.37-0.48), cortical (RR: 0.37; 95% CI, 0.36-0.55) and posterior subcapsular cataracts (RR: 0.48; 95% CI, 0.26-0.91). Similar reductions were observed in retinal haemorrhage or edema (RR: 0.44; 95% CI, 0.30-0.63) and the use of dry eye-related medication (RR: 0.44; 95% CI, 0.39-0.50).

GLP-1RAs were associated with lower risks of multiple age-related ocular conditions in non-diabetic older adults.