Glucagon-like Peptide-1 receptor agonists are not associated with an increased risk of progressing to vision-threatening diabetic retinopathy
Open accessAbstract
Purpose Glucagon-like peptide-1 receptor agonists (GLP-1RA) are used to treat type 2 diabetes mellitus (DM) by augmenting insulin release and sensitivity. We assessed the overall risk for development of vision-threatening diabetic retinopathy (VTDR), proliferative diabetic retinopathy (PDR), and diabetic macular edema (DME), among GLP-1RA users.Methods A retrospective cohort of patients with NPDR newly started on a GLP-1RA from a national insurance claims database was compared to a cohort of patients treated with other oral anti-diabetic agents and matched for age, sex, race, index year, and number of active diabetic medications. Exclusions occurred for < 2 years in the database before diagnosis; prior diagnoses of PDR, DME, vitreous hemorrhage, and/or other retinal vascular diseases; and prior intraocular treatment for VTDR.Results A total of 6093 users of GLP-1RA were matched to 14,122 controls. In the GLP-1RA cohort, 632 (10.1%), 76 (1.2%), and 544 (8.9%) patients progressed to VTDR, PDR, or DME, respectively. This is compared to 1332 (9.5%) VTDR, 165 (1.2%) PDR, or 1148 (8.1%) DME in the control group. Accounting for underlying DM severity with IPTW, no difference in hazard was seen in the GLP-1RA cohort compared to controls for progression to VTDR (HR = 1.02, 95%CI: 0.92–1.14 p = 0.69), DME (HR = 1.06, 95%CI: 0.95–1.1.9, p = 0.31), or PDR (HR = 0.81, 95%CI: 0.58–1.12, p = 0.20).Conclusion We found no difference in the risk for vision-threatening diabetic retinopathy, nor for its component diseases, DME or PDR, with GLP-1RA use compared to other oral anti-hyperglycemic agents in patients with NPDR.
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- Authors
- Tauqeer, Z., Bracha, P., Hua, P., Yu, Y., Cui, Q. N., & VanderBeek, B. L.
- Affiliations
- Associated Retinal Consultants (US)
- Wolfe Eye Clinic (US)
- University of Pennsylvania (US)
- Corresponding author
- VanderBeek, Brian L.
- Venue
- Ophthalmic Epidemiology
- Publisher
- Informa UK Limited
- Published
- 2024-10-10
- Volume
- 32
- Issue
- 4
- Pages
- 390-393
- ISSN
- 0928-6586 (ISSN-L)
- 1744-5086
- PMC
- PMC11982348
- OpenAlex
- W4403289459
- Cited by
- 16
- References
- 12
- Citations by year
- 2026: 8 · 2025: 8
- FWCI
- 6.36
- Type
- journal article
- Language
- en
- Open access
- green
- pmc.ncbi.nlm.nih.gov
- Locations
- Ophthalmic Epidemiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Eye Institute (K23EY025729, P30EY001583, R01EY034115)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Ophthalmology › Drug-Induced Ocular Toxicity
- Keywords
- GLP-1 receptor agonists, diabetic retinopathy, proliferative diabetic retinopathy, diabetic macular edema, non-proliferative diabetic retinopathy, type 2 diabetes, drug safety, retinal disease progression
- MeSH terms
- Glucagon-Like Peptide-1 Receptor Agonists, Adult, Aged, Diabetes Mellitus, Type 2, Diabetic Retinopathy, Female, Humans, Hypoglycemic Agents, Macular Edema, Male, Middle Aged, Retrospective Studies, Risk Factors, Disease Progression
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