GLP-1s Have Protective Benefit Against DME, Glaucoma Surgery

Posters presented during the American Academy of Ophthalmology 2026 Annual Meeting, held in New Orleans, Louisiana, from October 10-12, detailed the potential benefits of glucagon-like peptide-1 receptor agonists (GLP-1RA), with reduced incidence of diabetic macular edema (DME) among patients, as well as reduced need for glaucoma surgery when receiving the treatment.

Incidence of DME Reduced in Patients With Diabetic Retinopathy

In the first poster,¹ the researchers aimed to evaluate DME development in patients who had previously been diagnosed with diabetic retinopathy (DR). Outcomes were compared between patients who were taking metformin and patients who were taking a GLP-1RA.

All patients were 40 years or older and had been diagnosed with DR. Patients were split into 2 groups, those taking a GLP-1RA vs those who were using metformin, and by demographics, comorbidities, DR severity, and prior ocular treatments, as well as matched on a 1:1 basis. Cox models were used to assess the development of DME through a 7-year follow-up, with follow-up data collected at 1, 3, 5, and 7 years.

There were 3920 patients who were included in each cohort. DME development was similar between GLP-1RA and metformin through 1 year (12.2% vs 12.7%), but those taking GLP-1RAs had a lower rate of development through 3 years (24.3% vs 27.9%), 5 years (29.8% vs 35.9%), and 7 years (30.9% vs 39.5%).

Overall, the researchers concluded that GLP-1RAs had a protective association with the development of DME compared with metformin, indicating that this treatment has a favorable ocular safety profile.

Lower Risk of Filtering Surgery in Glaucoma

A second poster² evaluated how the use of GLP-1RAs could affect the need for traditional glaucoma surgery. The study population was made up of those who had been diagnosed with type 2 diabetes and glaucoma.

The researchers used a retrospective cohort study design to conduct their analysis. A total of 16,753 patients using GLP-1RAs and 16,753 patients not using GLP-1RAs were included in the study. Patients were 40 years or older, and all were matched 1:1 using propensity score matching. Adjusted HRs (aHRs) were calculated for trabeculectomy, tube shunt implantation, and cyclophotocoagulation (CPC) over 3 years.

The 3-year cumulative incidence of trabeculectomy (0.28% vs 0.63%), tube shunts (0.97% vs 2.12%), and CPC (0.39% vs 1.00%) were all significantly lower for those taking GLP-1RAs compared with those who were not. The Cox analysis confirmed lower hazards across all time points. Hazards were low for CPC (aHR, 0.38) and shunts (aHR, 0.47) through 2 years and all 3-year aHRs were significant.

The researchers concluded that GLP-1RAs were associated with a significantly lower risk of requiring filtering surgery and CPC. Future studies should be conducted in order to validate these results, including the addition of clinical parameters to measure the results more thoroughly.

The combination of the 2 posters increases the amount of evidence into how GLP-1RAs can be used to protect against worsening eye conditions.^1,2 Both analyses indicate that severe DME and glaucoma can be avoided with the use of GLP-1RAs in those living with diabetes. The analyses can help both primary care physicians and eye doctors prepare their patients for potential adverse effects and give a realistic projection into how these treatment methods will affect their eyes in the future.

References

1. Abboud I, Abdel-Jaber H, Bandaru D, et al. Association between GLP-1 receptor agonist use and reduced development of DME. Poster presented at: AAO 2026; October 10-12, 2026; New Orleans, LA. Abstract PO656.
2. Adelpour M, Abboud I, Serhan HA, Lee R, Sanvicente C, Elhusseiny AM. Assocation between GLP-1-receptor-agonist use and traditional glaucoma surgery. Poster presented at: AAO 2026; October 10-12, 2026; New Orleans, LA. Abstract PO154.