ReviewGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
Glucagon-like peptide-1 receptor agonists and diabetic retinopathy: a systematic review of diabetic retinopathy outcomes.
Review in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeGlucagon-like peptide-1 receptor agonists (GLP-1 RAs) have transformed the management of type 2 diabetes mellitus, offering glycemic, cardiovascular, and renal benefits; however, their impact on diabetic retinopathy (DR) remains uncertain.
methodsWe conducted a PRISMA 2020-guided systematic review prospectively registered in PROSPERO (CRD420251237987). We searched bibliographic databases and ClinicalTrials.gov through 31 October 2025 for studies reporting DR outcomes in adults with type 2 diabetes treated with GLP-1 RAs.
resultsThirty-one studies were included: ten randomized evidence reports (five major randomized controlled trials (RCTs) and five RCT-derived secondary or post hoc analyses) and twenty-one observational/real-world studies. Heterogeneity in baseline DR status, outcome definitions, outcome ascertainment methods, and follow-up precluded quantitative pooling. Aside from SUSTAIN-6-where DR complications showed a signal consistent with early worsening in the setting of rapid HbA1c reduction-no randomized trial demonstrated increased DR progression. Major cardiovascular outcome trials (LEADER, REWIND, EXSCEL, HARMONY) reported neutral retinal outcomes but largely relied on adverse-event reporting rather than standardized ophthalmic grading. Real-world cohorts yielded heterogeneous estimates, and residual confounding cannot be excluded, particularly where baseline retinopathy severity was incompletely characterized.
conclusionCurrent evidence regarding the effects of GLP-1 RAs on DR outcomes remains inconsistent, with no convincing evidence supporting an intrinsic retinotoxic effect. These findings reinforce the importance of baseline ophthalmic assessment and closer monitoring when advanced pre-existing DR and rapid glycemic improvement is anticipated. Interpretation of the various studies remains limited by heterogeneity in methods, outcome definitions, follow-up duration, and the lack of standardized retinal assessment protocols, including best-corrected visual acuity, fundus photography and limited use of OCT to adequately evaluate both macular and peripheral retinal disease.
Indexed as
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42541561What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.