Evidence mapPaperPMID 42541561Full record

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.

Catarina Francisco, João Sérgio Neves, Rita Laiginhas, Manuel Falcão

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In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Catarina FranciscoDepartment of Ophthalmology, Unidade Local de Saúde de Matosinhos, R. de Dr. Eduardo Torres, 4464-513 Sra. da Hora, Matosinhos, Portugal. catarina.francisco@sapo.pt.ORCID https://orcid.org/0000-0002-3152-542X
João Sérgio NevesDepartment of Endocrinology, Diabetes and Metabolism, Unidade Local de Saúde de São João, Porto, Portugal.
Rita LaiginhasDepartment of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal.
Manuel FalcãoDepartment of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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

Diabetic retinopathyGLP-1 receptor agonistsOptical coherence tomographyRetinal outcomesType 2 diabetes

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.