Potential Impact of GLP-1 Receptor Agonists on Diabetic Retinopathy Incidence and Outcomes

Recent research suggests that the use of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in individuals with type 2 diabetes (T2D) may have a complex effect on diabetic retinopathy (DR). A comprehensive study published online on August 11, 2025, in JAMA Network Open, indicates that while GLP-1 RAs are associated with a slightly increased risk of developing diabetic retinopathy, they may also confer benefits by reducing certain severe complications of the disease.

The study, conducted by Dr. David J. Ramsey and colleagues at the UMass Chan-Lahey School of Medicine, analyzed data from a large retrospective cohort involving over 185,000 adults with T2D and elevated hemoglobin A1c levels. Participants were divided based on whether they were prescribed GLP-1 RAs. Results showed that users of GLP-1 RAs had a hazard ratio of 1.07 for incident diabetic retinopathy, indicating a modest increased risk. However, when examining patients with preexisting DR, the medication was associated with reduced occurrences of serious complications such as vitreous hemorrhages, neovascular glaucoma, and blindness, with hazard ratios of 0.74, 0.78, and 0.77, respectively.

Notably, the study did not find a significant link between GLP-1 RA use and an increased risk of nonarteritic anterior ischemic optic neuropathy (NAION). The researchers emphasized the importance of regular eye screening for all patients with T2D on GLP-1 RAs to monitor potential development or progression of retinopathy. Interestingly, the findings suggest that while there may be a slight rise in retinopathy incidence, the overall risk of sight-threatening complications could be diminished, offering a nuanced perspective on the use of these medications.

This research underscores the need for continued ophthalmologic monitoring in diabetic patients receiving GLP-1 RAs and highlights the potential for these drugs to reduce vision loss risks despite a marginal increase in early retinopathy. As such, healthcare providers should consider both the benefits and risks when prescribing GLP-1 RAs and ensure patients undergo regular eye examinations.

Source: https://medicalxpress.com/news/2025-08-glp-receptor-agonists-incidence-diabetic.html