Studies Suggest GLP-1 Drug Use Linked to Lowered AMD Risk

Both of these studies found that GLP-1 therapy lowered dry AMD risk compared to outcomes of patients using other diabetes medications. Photo: Tanuj P. Banker, MD. Click image to enlarge. Given the increased use of glucagon-like peptide-1 (GLP-1) receptor agonist (RA) drugs over the past few years, there remains a need to establish whether this therapy is associated with age-related macular degeneration (AMD) risk, as has been proposed. In Ophthalmology Retina, two recent studies examined this potential development. The first compared the drug type to other weight loss pharmacotherapies, while the second involved other glucose-lowering medications. The first study noted that GLP-1 medication use was associated with a lower incidence of nonexudative and any (nonexudative, exudative or unspecified) AMD diagnoses compared with other weight loss medications.1 In the second, GLP-1 use was associated with a lower risk of nonexudative AMD.2The first retrospective study, which was based out of Medical University of South Carolina, assessed adults 50 years old and older without diabetes who were prescribed a GLP-1 agent or other weight loss med—phentermine, orlistat, setmelanotide, phentermine-topiramate or bupropion-naltrexone. The mean age at index was 58.0 in the GLP-1 group and 58.2 in the other group. Median follow-up time was 822 days for patients prescribed GLP-1s and 789 days for those prescribed other weight loss pharmacotherapy. Women comprised 84.8% of the GLP-1 agonist group and 83.8% of the other weight loss drug cohort. Most patients were Caucasian (78.7% and 78.4% in each cohort, respectively), as recorded in the electronic health record.1Compared with other weight loss therapies, GLP-1 receptor agonists were associated with a lower hazard of dry AMD (hazard ratio; HR: 0.47) and any AMD (HR: 0.61), with no difference for wet AMD (HR: 0.63).“Notably, BMI and A1c were similar between cohorts at baseline and follow-up, suggesting the lower rates of nonexudative or any AMD with GLP-1 RAs are not readily explained by weight loss or glycemic control, though residual time-varying mediation cannot be excluded,” this study’s authors wrote in their paper. “This observational study supports future investigations for GLP-1 RAs as candidates for AMD risk mitigation.”1In the second study, researchers from the Cleveland Clinic Cole Eye Institute retrospectively assessed GLP-1, SGLT-2i, metformin and insulin users who were 50 years old and older. After propensity score matching, each cohort included 7,561 patients. Patients with diabetic macular edema, severe or proliferative diabetic retinopathy, as well as those with a history of prior retinal surgeries were excluded. On average, GLP-1 agonist users were two to three years younger at the time of starting medication than patients in the other drug cohorts. Patients on GLP-1 agonist therapy also had the highest proportion of never-smokers (55% compared to 50% in SGLT-2i, 51% in metformin and 46% in insulin). Insulin users had a higher proportion of Black patients (20%) compared to the other cohorts (GLP-1 12%, SGLT-2i 13%, metformin 16%).2This study found that GLP-1 receptor agonist use conferred a lower risk of nonexudative AMD compared to insulin after adjusting for follow-up duration using data from an ophthalmic center. A similar trend of a protective effect of GLP-1 use on dry AMD development was seen when compared to insulin and metformin by one year and compared to SGLT-2i by three years of drug duration. However, more in-depth hazard analyses that decreased the number of subjects and the outcomes of interest showed no significant effects when compared to SGLT-2i or metformin.The researchers noted that their analyses may have been underpowered after propensity score matching to observe this relatively small and rare effect. Future work should ensure longer follow-up periods, larger sample sizes, and the use of imaging for diagnosis validation and staging, they proposed.“Given the promise of GLP-1 RA in the risk reduction of AMD and other ocular diseases, prospective trials should be considered to better characterize the potential protective effects of this medication class against ocular disease,” they concluded.2Click here and here for the journal sources. 1. Myers WK, Heath G, Rohrer B. Rate of age-related macular degeneration in patients prescribed glucagon-like peptide-1 receptor agonists or other weight loss therapy. Ophthalmol Retina. December 24, 2025. [Epub ahead of print].2. Joo JH, Zhao AH, Chalasani, et al. Impact of glucagon-like peptide-1 receptor agonists on age-related macular degeneration at a tertiary ophthalmology center. Ophthalmol Retina. December 22, 2025. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.