GLP-1 receptor agonists show no increased ocular disorder risk in type 2 diabetes meta-analysis

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Frontiers in Medicine Published June 2, 2026 Medically reviewed June 2, 2026 DOI ↗ By Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

Key Takeaway

Consider that GLP-1 receptor agonists may not raise ocular disorder risk in type 2 diabetes, based on observational meta-analysis.

This is a systematic review and meta-analysis of 28 observational studies examining the risk of ocular disorders in patients with type 2 diabetes treated with GLP-1 receptor agonists. The authors synthesized evidence on the risk of non-arteritic anterior ischemic optic neuropathy (NAION), glaucoma, and retinopathy compared to other antidiabetic treatments.

The meta-analysis found no increased risk for any ocular outcome. For NAION, the pooled risk ratio was 1.01 (95% CI, 0.62–1.64). For glaucoma, the hazard ratio was 0.84 (95% CI, 0.71–1.00). For retinopathy (new onset or progression), the hazard ratios were 0.96 (95% CI, 0.85–1.08) and 0.97 (95% CI, 0.83–1.14) from alternative estimates. All results indicated no difference in risk.

The authors note the limitations of the observational evidence, which cannot prove causality. The review did not report follow-up duration, absolute event numbers, or safety data. The practice relevance suggests optimal monitoring of these molecules.

Clinicians should interpret these findings as reassuring but preliminary, given the observational nature of the included studies.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedJun 2026

View Original Abstract ↓

IntroductionDifferent observational studies have analyzed the effects of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on the risk of ocular adverse events (AEs). The present meta-analysis aimed to assess the effects of GLP-1 RAs on the risk of ocular AEs, including retinopathy, glaucoma, and non-arteritic anterior ischemic optic neuropathy (NAION).MethodsA systematic review and meta-analysis of observational studies was conducted in PubMed, Embase, and Web of Science from 2006 to 2025. Studies involving individuals diagnosed with diabetes and/or obesity and overweight, receiving GLP-1 RAs, and evaluating outcomes related to ocular AEs were included. A random-effect meta-analysis approach was used. This study followed the PRISMA statement.ResultsA total of 28 observational studies (6 for semaglutide and 22 for all GLP-1 RAs) involving T2DM patients were included. When compared to other antidiabetic treatments, GLP-1 RAs did not increase the risk of developing ocular disorders such as NAION (RR, 1.01; 95% CI, 0.62–1.64; I2, 89%), glaucoma (HR, 0.84; 95% CI, 0.71–1.00; I2, 91%), and retinopathy (new onset or progression) [(HR, 0.96; 95% CI, 0.85–1.08; I2, 91%) (HR, 0.97; 95% CI, 0.83–1.14; I2, 65%)].ConclusionEven if no difference was observed between GLP-1 RAs and other antidiabetic medications for all safety outcomes evaluated, it is optimal to monitor the administration of these molecules.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251080120, identifier CRD420251080120.