GLP-1 Drug Users Had Up to 75% Lower Risk of Age-Related Macular Degeneration
GLP-1 drug users had significantly lower rates of dry macular degeneration compared to metformin, insulin, and SGLT-2 inhibitor users over 3 years of follow-up.
Quick Facts
What This Study Found
GLP-1 receptor agonist use was associated with a significantly lower risk of developing nonexudative age-related macular degeneration (AMD) compared to metformin, insulin, and SGLT-2 inhibitors. After 3 years of use, GLP-1 users had 75% lower AMD risk versus metformin (RR 0.25), 72% lower risk versus insulin (RR 0.28), and 58% lower risk versus SGLT-2 inhibitors (RR 0.42).
In the more rigorous propensity score-matched analysis controlling for additional confounders (BMI, hypertension, CKD, diabetes duration), the reduced risk remained significant compared to insulin (HR 0.45; 95% CI 0.27–0.76). This suggests GLP-1 drugs may have a protective effect on the retina independent of blood sugar control, since all comparator groups were also on glucose-lowering medications.
Key Numbers
How They Did This
Retrospective cohort study at a tertiary ophthalmology center analyzing patients aged ≥50 with at least 1 year of drug use between 2016 and 2025. Compared 30,515 GLP-1RA users against 48,906 SGLT-2i users, 286,066 metformin users, and 164,361 insulin users. After propensity score matching, each cohort included 7,561 patients. Logistic regression controlled for age, sex, race, smoking status, and HbA1c. Cox proportional hazards validation additionally matched for BMI, hypertension, CKD, and diabetes duration. Patients with diabetic macular edema, severe diabetic retinopathy, or prior retinal surgery were excluded.
Why This Research Matters
AMD is the leading cause of vision loss in people over 50 in developed countries, and there's no treatment for the dry (nonexudative) form. If GLP-1 drugs truly reduce AMD risk — as this large study suggests — it could represent an unexpected protective benefit for the tens of millions of people taking these medications. The finding is especially intriguing given the SUSTAIN-6 retinopathy signal, suggesting GLP-1 drugs may have complex, nuanced effects on the eye that differ between diabetic retinopathy and AMD.
The Bigger Picture
GLP-1 drugs continue to reveal unexpected health benefits beyond blood sugar and weight — from cardiovascular protection to reduced kidney disease, and now potentially eye health. The AMD finding is particularly significant because there's currently no treatment for dry AMD, which affects millions. It also adds nuance to the GLP-1 eye health story: while SUSTAIN-6 flagged increased diabetic retinopathy complications, this study suggests a protective effect against a different eye disease (AMD). Understanding these divergent eye effects could reveal important mechanistic insights about GLP-1 receptor signaling in the retina.
What This Study Doesn't Tell Us
This is a retrospective observational study from a single center — it shows association, not causation. Residual confounding is possible despite propensity score matching. The more rigorous CPH analysis in matched cohorts only confirmed the benefit versus insulin (not metformin or SGLT-2i). The study focused on nonexudative (dry) AMD only. GLP-1 users may differ from other drug users in ways not captured by the measured confounders.
Questions This Raises
- ?What mechanism could explain GLP-1's protective effect against AMD — is it anti-inflammatory, neuroprotective, or vascular?
- ?How do we reconcile this AMD protection with the SUSTAIN-6 finding of increased diabetic retinopathy complications?
- ?Would a prospective clinical trial confirm the protective effect, and does it extend to wet (exudative) AMD as well?
Trust & Context
- Key Stat:
- 75% lower AMD risk vs metformin After 3 years, GLP-1 drug users had a relative risk of just 0.25 for developing dry macular degeneration compared to metformin users — a striking potential protective effect.
- Evidence Grade:
- This is a large retrospective cohort study with propensity score matching and multiple statistical approaches. While the sample size and consistency are strengths, the single-center observational design and potential residual confounding warrant caution.
- Study Age:
- Published in 2025 using data through 2025, this is among the first large studies to specifically examine GLP-1 effects on AMD. The findings are preliminary but intriguing enough to motivate prospective research.
- Original Title:
- Impact of Glucagon-Like Peptide-1 Receptor Agonists on Age-Related Macular Degeneration at a Tertiary Ophthalmology Center.
- Published In:
- Ophthalmology. Retina (2025)
- Authors:
- Joo, Julia H, Zhao, Alison H, Chalasani, Meghana, Allan, Kevin C, Rachitskaya, Aleksandra V
- Database ID:
- RPEP-11649
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
Could taking a GLP-1 drug like Ozempic protect your eyesight?
This study suggests GLP-1 drug users develop dry AMD at lower rates than people on other diabetes medications. However, it's an observational study — it can't prove the drugs caused the protection. It's too early to recommend GLP-1 drugs for eye health, but it's a promising finding for people already taking them.
Didn't an earlier study show semaglutide could harm the eyes?
Yes — the SUSTAIN-6 trial found increased diabetic retinopathy complications with semaglutide. But that's a different eye condition from AMD. GLP-1 drugs may have different effects on different parts of the eye, which is why both findings are important to study further.
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Cite This Study
https://rethinkpeptides.com/research/RPEP-11649APA
Joo, Julia H; Zhao, Alison H; Chalasani, Meghana; Allan, Kevin C; Rachitskaya, Aleksandra V. (2025). Impact of Glucagon-Like Peptide-1 Receptor Agonists on Age-Related Macular Degeneration at a Tertiary Ophthalmology Center.. Ophthalmology. Retina. https://doi.org/10.1016/j.oret.2025.12.014
MLA
Joo, Julia H, et al. "Impact of Glucagon-Like Peptide-1 Receptor Agonists on Age-Related Macular Degeneration at a Tertiary Ophthalmology Center.." Ophthalmology. Retina, 2025. https://doi.org/10.1016/j.oret.2025.12.014
RethinkPeptides
RethinkPeptides Research Database. "Impact of Glucagon-Like Peptide-1 Receptor Agonists on Age-R..." RPEP-11649. Retrieved from https://rethinkpeptides.com/research/joo-2025-impact-of-glucagonlike-peptide1
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Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.