GLP-1 Receptor Agonists and Sight-Threatening Ophthalmic Complications in Patients With Type 2 Diabetes
Authors' conclusion
In this cohort study of individuals with T2D, GLP-1 RA use was associated with a modestly increased risk of incident DR; however, fewer patients experienced sight-threatening DR complications, including blindness, even among those with preexisting DR. These findings suggest that all patients with T2D treated with GLP-1 RAs, regardless of preexisting DR, should be regularly screened and monitored for potential complications of T2D.
Study context
- Population
- Adults (aged ≥18 years) with T2D and a recent HbA1c ≥6.5%, 2015–2022
- Exposure
- GLP-1 RA use vs no GLP-1 RA
- Outcome
- Incident diabetic retinopathy (DR), nonarteritic anterior ischemic optic neuropathy (NAION), or sight-threatening complications
- Follow-up
- 2-year follow-up
Methodological detailspropensity score matched, TriNetX database
- Propensity score matched
- TriNetX database
Main finding
As reported in the abstract
GLP-1 RA vs No GLP-1 RAHazard ratio (95% CI)
Incident DR
1.07(1.03–1.11)
NAION; no statistically significant difference
1.26(0.94–1.70)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Subgroup with preexisting DR (32 695 patients): sight-threatening complicationsGLP-1 RAvs No GLP-1 RAProgression to proliferative DR | 1.06 (0.97–1.15) | |
| Subgroup with preexisting DR (32 695 patients): sight-threatening complicationsGLP-1 RAvs No GLP-1 RADME | 0.98 (0.95–1.01) | |
| Subgroup with preexisting DR (32 695 patients): sight-threatening complicationsGLP-1 RAvs No GLP-1 RAVitreous hemorrhages | 0.74 (0.68–0.80) | |
| Subgroup with preexisting DR (32 695 patients): sight-threatening complicationsGLP-1 RAvs No GLP-1 RANeovascular glaucoma | 0.78 (0.68–0.88) | |
| Subgroup with preexisting DR (32 695 patients): sight-threatening complicationsGLP-1 RAvs No GLP-1 RABlindness | 0.77 (0.73–0.82) | |
| 0.512Hazard ratio (log scale) |
Original publication
GLP-1 Receptor Agonists and Sight-Threatening Ophthalmic Complications in Patients With Type 2 Diabetes. JAMA Netw Open. Published 1 August 2025. doi:10.
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