GLP-1 Receptor Agonist Exposure Linked to Neovascular AMD in Patients With Diabetes
FRIDAY, June 6, 2025 -- For patients with diabetes, exposure to glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is associated with an increased risk for incident neovascular age-related macular degeneration (nAMD) development, according to a study published online June 5 in JAMA Ophthalmology.
Reut Shor, M.D., from the University of Toronto in Canada, and colleagues examined the risk for developing nAMD associated with GLP-1 RA use in patients with diabetes in a population-based, retrospective cohort study. Patients aged 66 years or older with a diagnosis of diabetes and a minimum follow-up period of 12 months following initial diabetes diagnosis were included in the study. A matched cohort of 139,002 patients was created, with 46,334 patients exposed to GLP-1 RAs and 92,668 unexposed patients.
The researchers found that the exposed cohort had a higher incidence of nAMD than the unexposed cohort. Both unadjusted (crude) and adjusted models estimated hazard ratios for nAMD development of greater than 2.0 among patients exposed to GLP-1 RAs (crude hazard ratio, 2.11; adjusted hazard ratio, 2.21).
"While these findings align with the existing literature favoring a hypoxic-dependent mechanism of nAMD, diabetic retinopathy, and nonarteritic anterior ischemic optic neuropathy exacerbation, further research is needed to determine if there is a true cause-and-effect relationship in the association identified in this investigation and to understand the tradeoffs between the benefits and risks of GLP-1 RAs," the authors write.
"We want to know what the effects of these drugs are because we know that there are receptors for GLP-1 in the retina, and so it's reasonable to try to figure out what that might mean," said Talia Kaden, M.D., from Northwell Health in New York City, who was not involved in the study. "When you take into account all of the benefits that we know people have when they're on these medications, I don't think that this slight increase that we may be seeing in this particular cohort ... should be a reason for people to not be on these drugs."
One author disclosed ties to Alcon, Apellis, AbbVie, Bayer, Bausch Health, and Roche.
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