At the American Academy of Ophthalmology meeting, researchers reported that GLP-1 receptor agonists did not alter anti-VEGF treatment frequency in patients with diabetic macular edema (DME). The retrospective cohort study, using the IRIS Registry, matched 9,896 patients who started a GLP-1 agonist with an equal number of controls. Over 24 months after initiation, monthly injection probabilities showed no sustained or progressive change, and visual acuity and retinal thickness also remained stable.
The findings are clinically neutral, according to the investigators, and suggest that DME management should continue to be guided by ocular disease activity and anti-VEGF response. The study addresses a gap in prior research, which focused mainly on incident DME risk and had produced conflicting results—some suggesting GLP-1 drugs increase risk, others decrease it. This new data offers reassurance for patients already undergoing treatment.
Limitations include the heavy funneling of the dataset, as noted by discussant Jennifer Sun, which may limit generalizability. The authors acknowledged potential unmeasured differences despite rigorous propensity matching. Other studies at the meeting highlighted ongoing uncertainty: one found GLP-1 use associated with lower AMD risk after adjustment, while two AION studies showed earlier onset and faster sequential involvement in users. The authors call for further research to clarify these ophthalmic associations.