The use of glucagon-like peptide-1 (GLP-1) agonists, a popular second-line treatment for type 2 diabetes and obesity, was linked with a higher-risk of neovascular age-related macular degeneration (nAMD) in diabetic patients. These findings come from a recent population-based, retrospective cohort study in JAMA Ophthalmology.¹  

Specifically, Cox proportional hazard models, both unadjusted (crude) and adjusted, estimated hazard ratios for nAMD development of greater than 2.0 among diabetic patients exposed to GLP-1 agonists (exposed, 0.2% vs unexposed, 0.1%; difference, 0.1%; crude: HR, 2.11; 95% CI, 1.58-2.82; adjusted: HR, 2.21; 95% CI, 1.65-2.96), according to the study. 

The researchers arrived at this finding by using comprehensive administrative health and demographic data from patients in Ontario, Canada. Study inclusion criteria were patients age 66 or older who had diabetes and a minimum follow-up period of 12 months following this initial diagnosis.

Of 1,119, 517 eligible patients, a 1:2 matched cohort of 139,002 patients was created, including 46,334 patients who used GLP-1s and 92,668 unexposed matched patients. Additionally, the researchers used systemic comorbidities associated with any kind of AMD and socioeconomic status to calculate propensity scores.  

The study’s researchers concluded that further research is needed to clarify the exact pathophysiological mechanisms involved to comprehend the trade-offs between the benefits and risks of GLP-1s. 

For additional information on the association between GLP-1s and ocular conditions, check out the May 2025 issue of Optometric Management, where Dr. Sherrol Reynolds details the drug’s link with diabetic retinopathy. OM 

1. Shor R, Mihalache A, Noori A, et al. Glucagon-Like Peptide-1 Receptor Agonists and Risk of Neovascular Age-Related Macular Degeneration. JAMA Ophthalmol. 2025 Jun 5:e251455 doi:10.1001/jamaophthalmol.2025.1455.