{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T14:18:15Z","timestamp":1792505895440,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Exper Ophthalmology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To determine if glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RA) are associated with the development and progression of diabetic retinopathy (DR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search was conducted on PubMed, Cochrane Library, and Embase from inception to February 2024 to identify clinical studies reporting the development of and changes in DR as the primary outcome in patients with type 2 diabetes taking GLP\u20101RA, insulin, or oral antidiabetic medication (OAD). Two researchers independently completed the search and referred to a third as necessary. Data for meta\u2010analysis was pooled using a random\u2010effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Analysis of seven studies representing 242\u2009537 patients showed a significantly decreased risk of incidence of DR between GLP\u20101RA and insulin use (RR\u2009=\u20090.66, 95% CI (0.48, 0.91),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). There was no difference in the risk of DR complications (e.g., vitreous haemorrhage, retinal detachment, or requiring treatment with intravitreal injections, lasers, vitrectomy). Between GLP\u20101RA and OAD use, there was no difference in the risk of incidence of DR, while there was a significantly increased risk of DR complications (RR\u2009=\u20091.39, 95% CI (1.07, 1.80),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings indicate no elevated risk of incidence of DR linked to GLP\u20101RA compared to insulin. In fact, GLP\u20101RA may offer potential advantages over insulin regarding the overall incidence of DR. The increased risk of DR requiring treatment and associated complications in the GLP\u20101RA group compared to OAD may be due to the transient progression of DR associated with a rapid decrease in HbA1c \u2013 a phenomenon not specific to GLP\u20101RA and warrants further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ceo.14445","type":"journal-article","created":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T21:09:28Z","timestamp":1727384968000},"page":"67-75","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Impact of glucagon\u2010like peptide\u20101 receptor agonists on diabetic retinopathy: A meta\u2010analysis of clinical studies emphasising retinal changes as a primary outcome"],"prefix":"10.1111","volume":"53","author":[{"given":"Ishani","family":"Kapoor","sequence":"first","affiliation":[{"name":"Drexel University College of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swara M.","family":"Sarvepalli","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"D'Alessio","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4676-1844","authenticated-orcid":false,"given":"Majda","family":"Hadziahmetovic","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2023.2289"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042018814559725"},{"key":"e_1_2_8_4_1","unstructured":"GLP\u20101 Agonists [Internet]. Cleveland Clinic.2024.https:\/\/my.clevelandclinic.org\/health\/treatments\/13901-glp-1-agonists"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1607141"},{"issue":"7","key":"e_1_2_8_6_1","first-page":"874","article-title":"Early worsening of diabetic retinopathy in the Diabetes Control and Complications Trial","volume":"116","year":"1998","journal-title":"Arch Ophthalmol Chic Ill 1960"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.290.6471.811"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1603827"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31149-3"},{"key":"e_1_2_8_10_1","volume-title":"StatPearls [Internet]","author":"Collins L","year":"2022"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms232012428"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2337\/db15-0443"},{"key":"e_1_2_8_13_1","unstructured":"KapoorI HadziahmetovicM.GLP\u20101 receptor agonists and DR [Internet]. Retina Today. Bryn Mawr Communications. Accessed May 26 2022https:\/\/retinatoday.com\/articles\/2024-may-june\/glp-1-receptor-agonists-and-dr"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40261-023-01319-x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2022.108255"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-1815"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-2285"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-2532"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-2280"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2024.108692"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.2174\/1574886318666230420084701"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.4093\/dmj.2022.0221"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-023-02753-6"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13538"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.2.381"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2011.08.017"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2013.12.041"},{"key":"e_1_2_8_29_1","unstructured":"Novo Nordisk A\/S.Long\u2010term effects of semaglutide on diabetic retinopathy in subjects with type 2 diabetes [Internet]. Report No.: NCT03811561. Accessed December 31 2023https:\/\/clinicaltrials.gov\/study\/NCT03811561"},{"key":"e_1_2_8_30_1","unstructured":"Assistance Publique\u2010H\u00f4pitaux de Paris.Impact of incretin\u2010mimetic hypoglycaemic drugs on diabetic retinopathy in type 2 diabetic patients and study of biomarkers in the development of severe retinopathy: Angiosafe\u2010T2D Study 2 [Internet]. Report No. NCT02671864. 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