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Multicenter Study
. 2025 Aug;132(8):859-868.
doi: 10.1016/j.ophtha.2025.02.011. Epub 2025 Feb 18.

Risk of Glaucoma in Patients without Diabetes Using a Glucagon-Like Peptide 1 Receptor Agonist

Pranav Vasu  1 , Emily A Dorairaj  2 , Robert N Weinreb  3 , Alex S Huang  3 , Syril K Dorairaj  4
Affiliations
Multicenter Study

Risk of Glaucoma in Patients without Diabetes Using a Glucagon-Like Peptide 1 Receptor Agonist

Pranav Vasu et al. Ophthalmology. 2025 Aug.

Abstract

Purpose: To compare the risk of primary open-angle glaucoma (POAG) and ocular hypertension in patients with obesity taking glucagon-like peptide 1 receptor agonists (GLP-1RAs) versus alternative weight loss medications.

Design: A retrospective cohort study of the TriNetX research network was conducted by analyzing international electronic health record data from January 2004 through December 2024.

Participants: Patients without diabetes who had a diagnosis of being overweight or obesity who were treated with either GLP-1RAs or alternative weight loss medications, including orlistat, phentermine-topiramate, bupropion-naltrexone, or setmelanotide.

Methods: Patients were assessed for outcomes at 3 and 5 years. Propensity score matching (PSM) was conducted between cohorts matched for baseline demographics, comorbidities, and medication use. Risk ratios (RR) and 95% confidence intervals (CIs) were calculated subsequently.

Main outcome measures: Risk of POAG and ocular hypertension.

Results: After PSM, both cohorts comprised 61 057 patients. The risk of both POAG and ocular hypertension were significantly lower in the GLP-1RA group at both 3 and 5 years of follow-up. A 50.4% lower risk at 3 years (RR, 0.496; 95% CI, 0.371-0.664) and a 58.5% lower risk at 5 years (RR, 0.415; 95% CI, 0.316-0.545) for POAG developing was noted. Lower risks of 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) for ocular hypertension developing were noted.

Conclusions: In patients without diabetes, the use of GLP-1RAs exhibited a significantly lower risk of POAG and ocular hypertension compared with alternative weight loss therapy at 3-year and 5-year intervals.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Keywords: GLP-1 receptor agonists; Ocular hypertension; Primary open-angle glaucoma; Propensity score matching; Weight loss.

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Conflict of interest statement

Conflict of Interest: No conflicting relationship exists for any author.

References

    1. Cook C & Foster P Epidemiology of glaucoma: what’s new? Can. J. Ophthalmol. J. Can. Ophtalmol 47, 223–226 (2012). - PubMed
    1. Ofri R Intraocular pressure and glaucoma. Veterinary Clin. North Am. Exot. Anim. Pract 5, 391–406, vii–viii (2002). - PubMed
    1. Sommer A Intraocular pressure and glaucoma. Am. J. Ophthalmol 107, 186–188 (1989). - PubMed
    1. Goldberg I Relationship between intraocular pressure and preservation of visual field in glaucoma. Surv. Ophthalmol 48 Suppl 1, S3–7 (2003). - PubMed
    1. Lusthaus J & Goldberg I Current management of glaucoma. Med. J. Aust 210, 180–187 (2019). - PubMed

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