Glaucoma Risk Reduction as a Secondary Benefit of Glucagon-like Peptide-1 Receptor Agonists - A Review of Emerging Evidence

Sep 30, 2026

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), first developed for type 2 diabetes and later adopted for weight loss, have been reported to offer protective effects against glaucoma. This review synthesizes emerging clinical and preclinical evidence on the association between GLP-1 RA therapy and glaucoma risk. A literature search across PubMed, Embase, and Scopus identified 9 relevant studies, most showing statistically significant risk reduction, while one Mendelian randomization analysis did not support causality.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Abstract

Purpose

Methods

Results

Conclusions

Introduction

REVIEW ARTICLE Glaucoma Risk Reduction as a Secondary Benefit of Glucagon-like Peptide-1 Receptor Agonists: A Review of Emerging Evidence Mary V Lang1, Pranav Vasu2, Emily A Dorairaj3, Shibal Bhartiya4, Syril K Dorairaj5 Received on: 07 July 2025; Accepted on: 06 November 2025; Published on: 15 December 2025 AbstrAct Purpose: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), initially developed for type 2 diabetes (T2D) and later adopted for weight loss, have demonstrated potential protection against the development of glaucoma in various peer-reviewed publications. This review provides a synthesis of the emerging evidence evaluating the link between GLP-1 RA treatment and glaucoma risk. Methods: We performed a comprehensive literature search across PubMed, Embase (via OVID), and Scopus on May 28, 2025. Studies were included if they examined the association between GLP-1 RA use and glaucoma risk and presented novel quantitative data published in the last 6 years. Exclusion criteria included studies unrelated to glaucoma, those not evaluating GLP-1 RAs, and reviews without original data. Results: Of the 44 studies identified, 9 met inclusion criteria: 5 retrospective observational studies, 1 nested case-control study, 1 preclinical study, 1 systematic review and meta-analysis, and 1 Mendelian randomization study. Most studies found a statistically significant association between GLP-1 RA use and reduced glaucoma risk, with stronger effects observed with prolonged exposure in three studies. One preclinical study demonstrated that the GLP-1 RA NLY01 mitigated retinal neuroinflammation and protected ganglion cells in a mouse model. Proposed mechanisms include intraocular pressure (IOP) reduction, attenuation of oxidative stress, and direct neuroprotection via GLP-1 receptor activation. However, one Mendelian randomization study did not support a causal link. Conclusions: Current evidence suggests that GLP-1 RAs may confer a secondary benefit in reducing glaucoma risk, supported by both clinical and preclinical data. However, the predominance of retrospective studies, coupled with the lack of randomized controlled trials, limit causal inference. Further randomized controlled trials and mechanistic investigations are warranted to validate these findings and assess their translational potential in glaucoma prevention. Keywords: Glaucoma, Glucagon-like receptor agonists, Intraocular pressure. Journal of Current Glaucoma Practice (2025): 10.5005/jp-journals-10078-1501 IntroductIon Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) were first introduced in 2005 with the approval of exenatide for the treatment of type 2 diabetes (T2D).1 The initial GLP-1 RA, exenatide, required twice-daily injections due to its short half-life. Subsequent developments led to the creation of longer-acting formulations, such as liraglutide (once daily) and once-weekly agents such as dulaglutide and semaglutide, which improved patient adherence and convenience.1, 2 Key studies that played a role in the adoption of GLP-1 RAs include numerous randomized controlled trials demonstrating their efficacy in reducing HbA1c levels, promoting weight loss, and decreasing cardiovascular risk.3,4 GLP-1 RAs gained further popularity as weight-loss medications due to their ability to reduce appetite, leading to significant weight loss.5,6 The widespread use of these medications for metabolic purposes has increased their interest within ophthalmic care.7 Recent evidence has established the expression of GLP-1 receptors in retinal ganglion cells (RGCs).8 Glaucoma is characterized by the progressive degeneration and death of RGCs and their axons, resulting in irreversible vision loss if left untreated. This selective vulnerability of RGCs in glaucoma is well established in the medical literature, with multiple sources emphasizing that RGC loss is the hallmark of glaucomatous optic neuropathy.9–11 Given this, the preservation of RGC function

FAQs

What was the goal of this review on GLP-1 RAs and glaucoma?

To synthesize emerging evidence evaluating whether GLP-1 receptor agonist treatment is linked to glaucoma risk reduction.

How were eligible studies selected in this review?

The authors searched PubMed, Embase (via OVID), and Scopus and included studies that assessed GLP-1 RA use and glaucoma risk with novel quantitative data from the last 6 years.

What evidence suggests a potential mechanism for glaucoma risk reduction?

Proposed mechanisms include lowering intraocular pressure, reducing oxidative stress, and direct neuroprotection through GLP-1 receptor activation, supported by clinical and at least one preclinical study.

Sep 30, 2026

Uploaded by Well Done