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

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.