Michaeli Tomer, Khateb Samer, Levy Jaime
"Tzameret", Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel.
Medical Corps, Israel Defense Forces, Ramat Gan 52625, Israel.
J Clin Med. 2024 Oct 21;13(20):6269. doi: 10.3390/jcm13206269.
To examine the effects of glucagon-like-peptide-1 receptor agonists (GLP1-RAs) on diabetic retinopathy (DR) progression, visual acuity (VA), central subfield thickness (CST), and response to intravitreal injections (IVIs) in the Hadassah ophthalmological cohort. Of 4500 Hadassah patients with DR, 146 had a documented first course of GLP1-RA treatment lasting at least a year along with ophthalmological follow-up. Of these, 35 underwent at least two optical coherence tomography (OCT) exams with a one-year interval. These 35 GLP1-RA-naïve patients were compared to a control group of 31 patients with DR who did not receive GLP1-RA treatment. We compared demographics, medical records, ocular data, and OCT characteristics between the two study groups. At baseline, patients who received GLP1-RA treatment had a significantly higher prevalence of retinal detachment and vitreous hemorrhage, as well as a higher (though not statistically significant) prevalence of cardiovascular comorbidities compared to the control group. At the end of the follow-up period, the GLP1-RA group had a higher prevalence of DR progression compared to controls (3/19 vs. 0/20, respectively; = 0.106, Fisher's exact test), but also showed a better response to IVIs (27/35 vs. 17/31, respectively; unadjusted OR: 2.78, = 0.058; 95% CI: [0.963, 8.020], Pearson's chi-square test). However, vitreous hemorrhage and hyperreflective retinal foci were confounding factors (adjusted IVI response OR: 1.76, = 0.229, 95% CI: [0.553, 5.650], logistic regression). No significant differences were observed between the two groups in terms of change in visual acuity (-0.135 vs. -0.063 logMAR, respectively; = 0.664, Student's -test) or CST (-13.49 vs. -30.13 μm; = 0.464, Student's -test). This study presents preliminary findings showing no significant differences in DR progression, visual acuity, and CST between patients treated with GLP1-RA and control patients. Moreover, GLP1-RA therapy was not significantly associated with improved IVI response, with ocular parameters acting as confounding factors.
在哈达萨眼科队列研究中，探讨胰高血糖素样肽-1受体激动剂（GLP1-RAs）对糖尿病视网膜病变（DR）进展、视力（VA）、中心子野厚度（CST）以及玻璃体内注射（IVIs）反应的影响。在4500例患有DR的哈达萨患者中，146例有记录显示接受了至少为期一年的GLP1-RA治疗疗程并伴有眼科随访。其中，35例患者间隔一年接受了至少两次光学相干断层扫描（OCT）检查。将这35例未接受过GLP1-RA治疗的患者与31例未接受GLP1-RA治疗的DR患者组成的对照组进行比较。我们比较了两个研究组之间的人口统计学、病历、眼部数据和OCT特征。在基线时，接受GLP1-RA治疗的患者视网膜脱离和玻璃体出血的患病率显著更高，与对照组相比，心血管合并症的患病率也更高（尽管无统计学意义）。在随访期结束时，与对照组相比，GLP1-RA组DR进展的患病率更高（分别为3/19和0/20；P = 0.106，Fisher精确检验），但对IVIs的反应也更好（分别为27/35和17/31；未调整的OR：2.78，P = 0.058；95%CI：[0.963，8.020]，Pearson卡方检验）。然而，玻璃体出血和高反射性视网膜病灶是混杂因素（调整后的IVI反应OR：1.76，P = 0.229，95%CI：[0.553，5.650]，逻辑回归）。两组在视力变化方面（分别为-0.135和-0.063 logMAR；P = 0.664，Student t检验）或CST方面（分别为-13.49和-30.13μm；P = 0.464，Student t检验）未观察到显著差异。本研究提出的初步结果表明，接受GLP1-RA治疗的患者与对照患者在DR进展、视力和CST方面无显著差异。此外，GLP1-RA治疗与IVI反应改善无显著关联，眼部参数起混杂因素作用。
