GLP-1 Receptor Agonists Linked to Lower Risk of Age-Related Macular Degeneration: Study
USA: A large retrospective cohort study found that patients using GLP-1 receptor agonists (GLP-1RAs) had a significantly lower risk of both nonneovascular and neovascular age-related macular degeneration (AMD) compared with those taking other glucose-lowering or lipid-lowering medications. However, the rate of progression from nonneovascular to neovascular AMD was not significantly different between treatment groups.
According to the authors, while these observational findings are encouraging, experts emphasized that prospective clinical trials are still needed to confirm whether GLP-1RAs truly provide a protective effect against AMD risk.
The study, published in Ophthalmology Retina, was conducted by Kevin C. Allan and colleagues from the Cleveland Clinic. The researchers investigated whether GLP-1 receptor agonists (GLP-1RAs), commonly used to treat type 2 diabetes and obesity, affect the risk of neovascular age-related macular degeneration (AMD).
Using data from the TriNetX electronic health records network in the United States, the team analyzed adults aged 60 years and older with at least 1, 2, or 3 years of ophthalmology follow-up and documented medication use. Participants were categorized into GLP-1RA users, users of alternative glucose-lowering drugs, and users of lipid-lowering medications. Propensity score matching was performed to balance demographics, chronic disease burden, and disease severity across groups.
The study led to the following findings:
- Patients prescribed GLP-1 receptor agonists initially had a higher burden of chronic diseases and worse disease severity indicators compared to the comparator groups. After propensity matching, baseline characteristics became more balanced between groups.
- GLP-1RA use was associated with a significantly lower risk of developing nonneovascular age-related macular degeneration compared with alternative glucose-lowering medications at one, two, and three years of follow-up.
- The hazard ratios for nonneovascular AMD among GLP-1RA users were 0.79 at one year, 0.75 at two years, and 0.77 at three years, suggesting a sustained reduction in AMD risk over time.
- Compared with lipid-lowering medications, GLP-1RA therapy was also associated with lower rates of nonneovascular AMD after two and three years of treatment.
- Researchers observed a significant reduction in the risk of neovascular AMD across all evaluated time points in patients using GLP-1RAs compared with both alternative glucose-lowering and lipid-lowering therapies.
- Among patients who already had nonneovascular AMD at baseline, GLP-1RA treatment did not significantly decrease the risk of progression to neovascular AMD.
The authors noted that the findings suggest GLP-1RAs may offer a protective effect against AMD development without increasing the risk of advanced neovascular disease. Nevertheless, they cautioned that the retrospective observational design limits the ability to establish a direct causal relationship.
The researchers concluded that future prospective clinical trials are essential to determine whether GLP-1RAs could eventually play a role in AMD prevention strategies, particularly in older adults at elevated risk of retinal disease.
Reference:
Allan, K. C., Cohn, E. F., Bala, S., Kim, S. B., Kaelber, D. C., Singh, R. P., Talcott, K. E., Mammo, D. A., & Rachitskaya, A. V. (2026). Glucagon-Like Peptide-1 Receptor Agonist Use and Risk of Neovascular Age-Related Macular Degeneration in a National Cohort Study. Ophthalmology Retina, 10(4), 362-372. https://doi.org/10.1016/j.oret.2025.10.020
