{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T17:35:36Z","timestamp":1787333736511,"version":"build-2736575974"},"reference-count":17,"publisher":"BMJ","funder":[{"name":"Dracopolous and Hankins Uveitis Funds","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"name":"Wilmer Rising Professorship","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2026,8,14]]},"abstract":"<jats:sec>\n                    <jats:title>Background\/aims<\/jats:title>\n                    <jats:p>Fenofibrates may slow progression of diabetic retinopathy (DR). This study used the large international TriNetX database to evaluate progression of retinopathy and development of cataracts, primary open angle glaucoma (POAG) and diabetic macular oedema (DME) in patients with diabetes with and without fenofibrate use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cohort study, ICD10 codes and RxNorm were used to identify patients in the TriNetX database aged \u226518 years with a diagnosis of diabetes mellitus (DM), with mild or moderate non-proliferative diabetic retinopathy (NPDR) and with and without fenofibrate use from December 2014 through December 2024. ORs were calculated to analyse the proportion of individuals with mild or moderate NPDR using fenofibrate who developed vision-threatening DR (VTDR, defined as severe NPDR or proliferative DR), cataracts, POAG or DME compared with those not taking fenofibrate. Those with cataracts, POAG or DME at baseline were excluded from their respective outcomes analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After propensity score matching, 4316, 4200, 4073 and 4571 individuals prescribed fenofibrate were compared with the same number who were not prescribed fenofibrate for progression to VTDR, cataract, POAG or DME, respectively. The ORs for DR progression (OR 0.528, 95%\u2009CI 0.333 to 0.838; p=0.0059), cataract (OR 0.585, 95%\u2009CI 0.441 to 0.774; p=0.0002) and DME (OR 0.316, 95%\u2009CI 0.243 to 0.411; p&lt;0.0001) development were lower for individuals taking fenofibrate compared with those not taking fenofibrate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Fenofibrate use is associated with significantly lower risk of developing VTDR, cataracts and DME in patients with mild or moderate NPDR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2026-329642","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T17:20:14Z","timestamp":1787332814000},"page":"bjo-2026-329642","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Association of fenofibrate use with progression of ocular disease in individuals with diabetes"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2578-8646","authenticated-orcid":false,"given":"Courtney","family":"Oliver","sequence":"first","affiliation":[{"name":"Drexel University College of Medicine, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan K","family":"Berkenstock","sequence":"additional","affiliation":[{"name":"Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5171-6709","authenticated-orcid":false,"given":"Mira M","family":"Sachdeva","sequence":"additional","affiliation":[{"name":"Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"2026082110200787000_bjo-2026-329642v1.1","unstructured":"Sidhu G , Tripp J . Fenofibrate. StatPearls - NCBI Bookshelf, 2023. Available: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK559219\/"},{"key":"2026082110200787000_bjo-2026-329642v1.2","doi-asserted-by":"crossref","DOI":"10.1007\/s11892-016-0786-7","article-title":"Fenofibrate and Diabetic Retinopathy","volume":"16","author":"Knickelbein","year":"2016","journal-title":"Curr Diab Rep"},{"key":"2026082110200787000_bjo-2026-329642v1.3","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1016\/S0140-6736(07)61607-9","article-title":"Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomised controlled trial","volume":"370","author":"Keech","year":"2007","journal-title":"The Lancet"},{"key":"2026082110200787000_bjo-2026-329642v1.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1001288"},{"key":"2026082110200787000_bjo-2026-329642v1.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2014.07.019"},{"key":"2026082110200787000_bjo-2026-329642v1.6","doi-asserted-by":"crossref","DOI":"10.1056\/EVIDoa2400179","article-title":"Effect of Fenofibrate on Progression of Diabetic Retinopathy","volume":"3","author":"Preiss","year":"2024","journal-title":"NEJM Evid"},{"key":"2026082110200787000_bjo-2026-329642v1.7","unstructured":"Foundation for Vision Research . PROTOCOL AF - Foundation for Vision Research, 2025. Available: https:\/\/fvr.org\/clinical-trials\/diabetic-retinopathy-2\/protocolaf\/"},{"key":"2026082110200787000_bjo-2026-329642v1.8","unstructured":"ANZCTR . ANZCTR - Registration, 2025. Available: https:\/\/anzctr.org.au\/Trial\/Registration\/TrialReview.aspx?ACTRN=12611000249954"},{"key":"2026082110200787000_bjo-2026-329642v1.9","doi-asserted-by":"crossref","first-page":"98","DOI":"10.4103\/ijo.IJO_566_17","article-title":"Efficiency of fenofibrate in facilitating the reduction of central macular thickness in diabetic macular edema","volume":"66","author":"Srinivasan","year":"2018","journal-title":"Indian J Ophthalmol"},{"key":"2026082110200787000_bjo-2026-329642v1.10","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1002\/cpt.1176","article-title":"Use of Lipid\u2010Lowering Drugs and the Risk of Cataract: A Population\u2010Based Nested Case\u2010Control Study","volume":"105","author":"Bezin","year":"2019","journal-title":"Clin Pharma and Therapeutics"},{"key":"2026082110200787000_bjo-2026-329642v1.11","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/fcp.12496","article-title":"Are lipid-lowering drugs associated with a risk of cataract? A pharmacovigilance study","volume":"33","author":"Despas","year":"2019","journal-title":"Fundam Clin Pharmacol"},{"key":"2026082110200787000_bjo-2026-329642v1.12","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph19042415","article-title":"Relationship between Using Fibrate and Open-Angle Glaucoma in Hyperlipidemic Patients: A Population-Based Cohort Study","volume":"19","author":"Tsai","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2026082110200787000_bjo-2026-329642v1.13","unstructured":"Lee S , Paul ME , Kitayama K , et al . Associations between Use of Cholesterol Medications and Glaucoma in the National Institutes of Health All of Us Research Program, 2023. Available: https:\/\/iovs.arvojournals.org\/article.aspx?articleid=2785741"},{"key":"2026082110200787000_bjo-2026-329642v1.14","doi-asserted-by":"publisher","DOI":"10.1016\/S0953-6205(03)90001-X"},{"key":"2026082110200787000_bjo-2026-329642v1.15","doi-asserted-by":"crossref","first-page":"376","DOI":"10.17305\/bb.2022.8534","article-title":"Anti-inflammatory role of fenofibrate in treating diseases","volume":"23","author":"Jin","year":"2023","journal-title":"Biomol Biomed"},{"key":"2026082110200787000_bjo-2026-329642v1.16","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-004-1588-z"},{"key":"2026082110200787000_bjo-2026-329642v1.17","doi-asserted-by":"crossref","first-page":"626","DOI":"10.3928\/23258160-20231017-01","article-title":"Impact of Dyslipidemia Medications on the Prevalence of Diabetic Retinopathy Among a Large US Cohort","volume":"54","author":"Chadalavada","year":"2023","journal-title":"Ophthalmic Surg Lasers Imaging Retina"}],"container-title":["British Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjo-2026-329642","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T17:20:16Z","timestamp":1787332816000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjo.bmj.com\/lookup\/doi\/10.1136\/bjo-2026-329642"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":17,"alternative-id":["10.1136\/bjo-2026-329642"],"URL":"https:\/\/doi.org\/10.1136\/bjo-2026-329642","relation":{},"ISSN":["0007-1161","1468-2079"],"issn-type":[{"value":"0007-1161","type":"print"},{"value":"1468-2079","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]}}}