Glucagon-like Peptide-1 Receptor Agonists and Risk for Anterior Ischemic Optic Neuropathy : A Nationwide Cohort Study.

Use of GLP-1 receptor agonists is associated with a nearly twofold increased risk of anterior ischemic optic neuropathy in type 2 diabetes patients, but absolute risk remains small.

• Why it matters: Understanding potential adverse effects of GLP-1RAs is crucial as they are widely used for diabetes management, yet the link to optic nerve ischemia is uncertain, risking patient safety and treatment decisions.
• What they did: A nationwide cohort study in Sweden compared GLP-1RA initiators with SGLT-2 inhibitor users, analyzing 107,518 and 185,898 patients respectively, over a median follow-up of about 1.6 years, assessing AION incidence through national health registers.
• The result: While the relative risk of AION was higher with GLP-1RAs, the absolute risk difference was minimal (0.02% at 1 year), and risk estimates diminished when focusing on patients on metformin, indicating residual confounding likely influences the findings.