Association between Glucagon-like Peptide-1 Receptor Agonist Use and Nonarteritic Anterior Ischemic Optic Neuropathy...

Area of Science:

• Ophthalmology
• Endocrinology
• Pharmacology

Background:

• Optic disc drusen are common, benign retinal nerve fiber layer deposits.
• Type-2 diabetes and obesity are prevalent conditions associated with microvascular complications.
• Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for type-2 diabetes and obesity management.

Purpose of the Study:

• To investigate the association between glucagon-like peptide-1 receptor agonist use and the risk of nonarteritic anterior ischemic optic neuropathy (NAION) in adults with optic disc drusen.
• To assess potential safety concerns of GLP-1 RAs in a specific patient population at risk for vascular events.

Main Methods:

• Retrospective cohort study utilizing electronic health records.
• Inclusion criteria: adults with diagnosed optic disc drusen and either type-2 diabetes or obesity.
• Exposure defined as new use of glucagon-like peptide-1 receptor agonists; outcome as incident NAION.

Main Results:

• No statistically significant increase in the hazard of nonarteritic anterior ischemic optic neuropathy was observed in patients exposed to glucagon-like peptide-1 receptor agonists compared to unexposed patients.
• A trend towards increased risk was noted, but did not reach statistical significance, indicating a need for continued monitoring.
• Confidence intervals suggested that moderate increases in risk could not be definitively excluded.

Conclusions:

• Glucagon-like peptide-1 receptor agonist therapy does not appear to be associated with a statistically significant increased risk of nonarteritic anterior ischemic optic neuropathy in adults with optic disc drusen and type-2 diabetes or obesity.
• While current evidence suggests safety, ongoing vigilance and further research are warranted to fully elucidate any potential association, especially concerning moderate risk increases.