Risk of Age‐Related Ocular Diseases in Non‐Diabetic Adults With Obesity Using Glucagon‐Like Peptide 1 Receptor Agonists

Aims To assess whether glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) are associated with a lower incidence of age‐related ocular diseases in non‐diabetic older adults with overweight or obesity. Materials and Methods We conducted a retrospective, propensity score–matched cohort study using the TriNetX global research network. Non‐diabetic, overweight or obese adults aged ≥ 60 years with an ophthalmic disease–naïve baseline were enrolled. Patients receiving liraglutide or semaglutide were matched 1:1 with users of alternative weight‐loss medications (bupropion–naltrexone, phentermine–topiramate, setmelanotide or orlistat). Outcomes included up to 5‐year risks of incident cataract, age‐related macular degeneration (AMD), ocular hypertension, primary open‐angle glaucoma (POAG) and dry eye syndrome (DES). Results After matching, 68 536 patients were included (34 268 per group). GLP‐1RAs use was significantly associated with a lower 5‐year risk of cataract (RR: 0.45; 95% CI, 0.40–0.50), AMD (RR: 0.33; 95% CI, 0.23–0.48), ocular hypertension (RR: 0.56; 95% CI, 0.34–0.91), POAG (RR: 0.50; 95% CI, 0.32–0.78) and DES (RR: 0.36; 95% CI, 0.31–0.42). Sensitivity analyses consistently demonstrated a lower risk across cataract subtypes, including nuclear (RR: 0.42; 95% CI, 0.37–0.48), cortical (RR: 0.37; 95% CI, 0.36–0.55) and posterior subcapsular cataracts (RR: 0.48; 95% CI, 0.26–0.91). Similar reductions were observed in retinal haemorrhage or edema (RR: 0.44; 95% CI, 0.30–0.63) and the use of dry eye‐related medication (RR: 0.44; 95% CI, 0.39–0.50). Conclusions GLP‐1RAs were associated with lower risks of multiple age‐related ocular conditions in non‐diabetic older adults.