GLP-1 Drugs Cut Glaucoma Risk in Nondiabetic Obesity

TOPLINE:

In patients without diabetes diagnosed with overweight or obesity, the use of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) led to a greater reduction in the risks for primary open-angle glaucoma and ocular hypertension at 3 and 5 years of treatment compared with alternative medications for weight loss.

METHODOLOGY:

• Researchers conducted a retrospective cohort study by analyzing data from the electronic health records in a federal health research network collected between 2004 and 2024.
• They evaluated the effectiveness of GLP-1 RAs and alternative weight loss medications in reducing the risks for eye complications in patients without diabetes diagnosed with overweight or obesity.
• The patients were classified into two cohorts: Those receiving the GLP-1 RAs semaglutide or liraglutide and those receiving orlistat, phentermine-topiramate, bupropion-naltrexone, or setmelanotide.
• The cohorts were propensity score matched on the basis of baseline demographic characteristics, comorbidities, and use of medication, resulting in 61,057 patients receiving GLP-1 RAs (mean age, 66.9 years; 69.3% women) and 61,057 patients receiving alternative medications (mean age, 66.8 years; 69% women).
• The primary outcomes were the risks for primary open-angle glaucoma and ocular hypertension assessed at 3- and 5-year follow-ups; the secondary outcomes included body mass index (BMI) and the risks for stroke, myocardial infarction, pulmonary embolism, and death assessed at the same time intervals.

TAKEAWAY:

• Compared with patients receiving alternative weight loss medications, those receiving GLP-1 RAs showed a 50.4% and 58.5% reduced risk for primary open-angle glaucoma at 3 years (risk ratio [RR], 0.496; 95% CI, 0.371-0.664) and 5 years (RR, 0.415; 95% CI, 0.316-0.545), respectively.
• The risk for ocular hypertension was reduced by 55.9% at 3 years (RR, 0.441; 95% CI, 0.318-0.611) and 65.8% at 5 years (RR, 0.342; 95% CI, 0.250-0.466) in patients receiving GLP-1 RAs compared with those receiving alternative medications.
• Reductions in BMI were greater in patients receiving GLP-1 RAs than in those receiving alternative weight loss medications at both follow-up periods (P P
• The risks for stroke, myocardial infarction, pulmonary embolism, and death were significantly reduced in patients receiving GLP-1 RAs compared with those receiving alternative weight loss medications at both follow-up periods.

IN PRACTICE:

“Our study provides a unique insight into the expanding potential of GLP-1 RAs in ophthalmology as it assesses systemic and ocular health benefits of GLP-1 RAs compared to alternative weight loss medications,” the authors of the study wrote. “The neuroprotective and anti-inflammatory properties of GLP-1RAs suggest these benefits may extend to populations beyond those studied, underscoring the potential global relevance of these findings,” they added.

SOURCE:

This study was led by Pranav Vasu, MPH, of the Department of Medicine at the Creighton University School of Medicine in Phoenix. It was published online February 18, 2025, in Ophthalmology.

LIMITATIONS:

This study relied on International Classification of Diseases and Current Procedural Terminology coding and assumed uniform practices for diagnosis across physicians. BMI, as a dynamic variable, may have served as a potential confounding factor in the risk assessment for the primary outcomes. Data on intraocular pressure were unavailable, and medication adherence could not be directly assessed.

DISCLOSURES:

This study was supported by the National Institutes of Health, the Research to Prevent Blindness David L. Epstein Career Advancement Award in Glaucoma Research sponsored by Alcon, and an unrestricted grant from Research to Prevent Blindness. Two authors reported serving as consultants for and having financial ties with several pharmaceutical, eye care, and biotechnology companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.