{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:42:02Z","timestamp":1792514522072,"version":"4.5.0"},"reference-count":40,"publisher":"American Diabetes Association","issue":"3","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"name":"Doris Zimmern HKU-Cambridge Hughes Hall Fellowship","award":["2024\/25"],"award-info":[{"award-number":["2024\/25"]}]},{"name":"Li Shu Pui Medical Foundation Fellowship","award":["2022"],"award-info":[{"award-number":["2022"]}]},{"name":"Hong Kong Research Grants Council Clinical Research Fellowship","award":["2024\/25"],"award-info":[{"award-number":["2024\/25"]}]},{"name":"Seed Funding for Basic Research\/ Translational and Applied Research","award":["104006735, 109000417, 109001395"],"award-info":[{"award-number":["104006735, 109000417, 109001395"]}]},{"name":"Hong Kong Research Grants Council General Research Fund","award":["GRF 17110122 and 17108523"],"award-info":[{"award-number":["GRF 17110122 and 17108523"]}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Data concerning glucagon-like peptide 1 receptor agonists (GLP-1 RAs) on risk of ischemic optic neuropathy (ION) are conflicting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>We synthesize current evidence of GLP-1 RAs on risk of optic nerve or vision-threatening events from randomized controlled trials (RCTs) in patients with type 2 diabetes or cardiometabolic diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA SOURCE<\/jats:title>\n                    <jats:p>A total of 83,288 participants with type 2 diabetes\/cardiometabolic diseases from 20 published RCTs were analyzed following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY SELECTION<\/jats:title>\n                    <jats:p>RCTs investigating GLP-1 RAs for type 2 diabetes\/cardiometabolic disease populations and reported optic nerve or vision-related adverse events were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA EXTRACTION<\/jats:title>\n                    <jats:p>Primary outcome was a composite of optic nerve and\/or vision-threatening serious adverse events, including ION, ocular ischemic syndrome, papilledema, blindness, blurred vision, visual impairment, and reduced visual acuity. Odds ratios (ORs) were derived.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA SYNTHESIS<\/jats:title>\n                    <jats:p>Type 2 diabetes occurred in 76.4% of participants. Over mean follow-up duration of 2.97 years (estimated cumulative exposure of 240,334 patient-years), GLP-1 RA use was not associated with increased risk of primary end point (OR 1.20, 95% CI 0.73\u20131.97, I2 = 0%). Prespecified individual adverse events, including ION (OR 1.50, 95% CI 0.49\u20134.63), and vision loss\/disturbance events (OR 1.08, 95% CI 0.60\u20131.94) were not significantly associated with GLP-1 RA use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LIMITATIONS<\/jats:title>\n                    <jats:p>RCTs reported vision-threatening events as adverse events rather than as prespecified outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Based on a large number of patients who contributed to a meta-analysis of RCTs involving participants with type 2 diabetes and cardiometabolic disease, GLP-1 RAs were not associated with an increased risk of optic nerve\/vision-threatening events.<\/jats:p>\n                  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