Glucagon-like peptide 1 receptor agonist use is associated with reduced risk for glaucoma
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Abstract
BACKGROUND/AIMS: Glucagon-like peptide-1 receptor (GLP-1R) agonists regulate blood glucose and are commonly used to treat type 2 diabetes mellitus. Recent work showed that treatment with the GLP-1R agonist NLY01 decreased retinal neuroinflammation and glial activation to rescue retinal ganglion cells in a mouse model of glaucoma. In this study, we used an insurance claims database (Clinformatics Data Mart) to examine whether GLP-1R agonist exposure impacts glaucoma risk. METHODS: A retrospective cohort of patients who initiated a new GLP-1R agonist was 1:3 age, gender, race, classes of active diabetes medications and year of index date matched to patients who initiated a different class of oral diabetic medication. Inverse probability of treatment weighting (IPTW) was used within a multivariable Cox proportional hazard regression model to test the association between GLP-1R agonist exposure and a new diagnosis of primary open-angle glaucoma, glaucoma suspect or low-tension glaucoma. RESULTS: Cohorts were comprised of 1961 new users of GLP-1R agonists matched to 4371 unexposed controls. After IPTW, all variables were balanced (standard mean deviation <|0.1|) between cohorts. Ten (0.51%) new diagnoses of glaucoma were present in the GLP-1R agonist cohort compared with 58 (1.33%) in the unexposed controls. After adjustment, GLP-1R exposure conferred a reduced hazard of 0.56 (95% CI: 0.36 to 0.89, p=0.01), suggesting that GLP-1R agonists decrease the risk for glaucoma. CONCLUSIONS: GLP-1R agonist use was associated with a statistically significant hazard reduction for a new diagnosis of glaucoma. Our findings support further investigations into the use of GLP-1R agonists in glaucoma prevention.
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GLP-1RAs have most strongly been linked to a protective effect on glaucoma.
“Within the ophthalmologic space, GLP-1RAs have most strongly been linked to a protective effect on glaucoma.28–30”
From The Effect of Semaglutide and GLP-1 RAs on Risk of Nonarteritic Anterior Ischemic Optic Neuropathy (2025) · cites this paper as [29]
The Discussion reports a significantly lower hazard of a new glaucoma diagnosis among patients with diabetes exposed to GLP-1R agonists, supporting the protective association. It does not compare the strength of that association with other ophthalmologic effects, so it does not establish the claim’s “most strongly” qualifier. (LLM, conf=0.82)
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Influential
- Authors
- Sterling, J., Hua, P., Dunaief, J. L., Cui, Q. N., & VanderBeek, B. L.
- Affiliations
- University of Pennsylvania (US)
- Corresponding author
- Cui, Qi N
- VanderBeek, Brian L
- Venue
- British Journal of Ophthalmology
- Publisher
- BMJ
- Published
- 2021-08-19
- Volume
- 107
- Issue
- 2
- Pages
- 215-220
- ISSN
- 0007-1161 (ISSN-L)
- 1468-2079
- PMC
- PMC8857286
- OpenAlex
- W3194224562
- Cited by
- 75
- References
- 29
- Citations by year
- 2026: 20 · 2025: 21 · 2024: 18 · 2023: 9 · 2022: 3 · 2021: 4
- FWCI
- 7.61
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- British Journal of Ophthalmology (publishedVersion)
- medRxiv (acceptedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health-National Eye Institute (F30EY032339, K08EY029765, K12EY015398, K23EY025729, T32EY007035)
- Research to Prevent Blindness (N/A)
- University of Pennsylvania Core (P30EYEY001583)
- Topics
- Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
- Health Sciences › Medicine › Ophthalmology › Drug-Induced Ocular Toxicity
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- GLP-1 receptor agonists, glaucoma, primary open-angle glaucoma, normal-tension glaucoma, glaucoma suspects, type 2 diabetes, glaucoma prevention, retinal neuroprotection, drug safety
- MeSH terms
- Glucagon-Like Peptide-1 Receptor, Glucagon-Like Peptide-1 Receptor Agonists, Animals, Diabetes Mellitus, Type 2, Glaucoma, Open-Angle, Retrospective Studies, Mice, Glucagon-Like Peptide 1
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