Glaucoma Risk Reduction as a Secondary Benefit of Glucagon-like Peptide-1 Receptor Agonists: A Review of Emerging Evidence.

PURPOSE: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), initially developed for type 2 diabetes (T2D) and later adopted for weight loss, have demonstrated potential protection against the development of glaucoma in various peer-reviewed publications. This review provides a synthesis of the emerging evidence evaluating the link between GLP-1 RA treatment and glaucoma risk.

METHODS

We performed a comprehensive literature search across PubMed, Embase (via OVID), and Scopus on May 28, 2025. Studies were included if they examined the association between GLP-1 RA use and glaucoma risk and presented novel quantitative data published in the last 6 years. Exclusion criteria included studies unrelated to glaucoma, those not evaluating GLP-1 RAs, and reviews without original data.

RESULTS

Of the 44 studies identified, 9 met inclusion criteria: 5 retrospective observational studies, 1 nested case-control study, 1 preclinical study, 1 systematic review and meta-analysis, and 1 Mendelian randomization study. Most studies found a statistically significant association between GLP-1 RA use and reduced glaucoma risk, with stronger effects observed with prolonged exposure in three studies. One preclinical study demonstrated that the GLP-1 RA NLY01 mitigated retinal neuroinflammation and protected ganglion cells in a mouse model. Proposed mechanisms include intraocular pressure (IOP) reduction, attenuation of oxidative stress, and direct neuroprotection via GLP-1 receptor activation. However, one Mendelian randomization study did not support a causal link.

CONCLUSIONS

Current evidence suggests that GLP-1 RAs may confer a secondary benefit in reducing glaucoma risk, supported by both clinical and preclinical data. However, the predominance of retrospective studies, coupled with the lack of randomized controlled trials, limit causal inference. Further randomized controlled trials and mechanistic investigations are warranted to validate these findings and assess their translational potential in glaucoma prevention.

HOW TO CITE THIS ARTICLE: Lang MV, Vasu P, Dorairaj EA, et al. Glaucoma Risk Reduction as a Secondary Benefit of Glucagon-like Peptide-1 Receptor Agonists: A Review of Emerging Evidence. J Curr Glaucoma Pract 2025;19(4):223-228.