The Impact of Glucagon-Like Peptide-1 Receptor Agonists on Risk of Retinal Vascular Occlusions

Purpose: To investigate whether glucagon-like peptide-1 receptor agonists are protective against retinal vascular occlusions. Methods: Using a large aggregated, de-identified electronic health records data platform in the United States, patients with type 2 diabetes ages ≥18 years prescribed glucagon-like peptide-1 receptor agonists or non-glucagon-like peptide-1 receptor agonists (controls) and having ophthalmology follow-up of at least 1, 3, or 5 years were included. The glucagon-like peptide-1 receptor agonist and control cohorts were propensity score matched (1:1) on demographics and risk factors, and outcomes were compared at 1, 3, and 5 years. Hazard ratios (HRs) with 95% CIs were reported, with significance defined as P < .05. Results: After matching, each cohort comprised 53 413 patients after 1 year, 25 738 patients after 3 years, and 14 695 patients after 5 years. Significantly reduced risk of all vascular occlusions was observed in the glucagon-like peptide-1 receptor agonist cohort at 1 year (HR, 0.66, 95% CI, 0.54-0.80), 3 years (HR, 0.71, 95% CI, 0.59-0.86), and 5 years (HR, 0.79, 95% CI, 0.64-0.97). Retinal vein occlusion risk was significantly reduced in the glucagon-like peptide-1 receptor agonist cohort up to 3 years (HR, 0.75, 95% CI, 0.60-0.94), but not after 5 years (HR, 0.83, 95% CI, 0.64-1.08). While there was no reduction in retinal artery occlusion risk at 1 year (HR, 0.69, 95% CI, 0.48-1.00), there were significant reductions at later time points. Conclusions: Results suggest that glucagon-like peptide-1 receptor agonists may reduce the risk of retinal vascular occlusions. Additional prospective trials and analysis of long-term outcomes are needed to further investigate this association.