Asif Maheen, Asif Aliza, Rahman Ummi Aiman, Farooqi Hanzala Ahmed, Fatima Oshaz, Ali Waqar, Jafar Uzair, Jaber Mohammed Hammad
Services Institute of Medical Sciences, Lahore, Pakistan.
Department of Endocrinolgy, King Edward Medical University, Lahore, Pakistan.
Endocrinol Diabetes Metab. 2025 Jul;8(4):e70059. doi: 10.1002/edm2.70059.
Glaucoma, a leading cause of irreversible blindness, is particularly prevalent among individuals with Type 2 Diabetes Mellitus (T2DM), a known risk factor for the disease. This systematic review and meta-analysis aimed to evaluate the incidence of glaucoma in T2DM patients treated with Glucagon-Like Peptide 1 Receptor Agonists (GLP-1RAs) compared to those using other antihyperglycaemic agents.
A comprehensive search of literature was conducted using MEDLINE (PubMed), the Cochrane Library, Google Scholar, and Scopus up to September 14, 2024. Observational studies that reported the incidence of glaucoma among T2DM patients using GLP-1RAs versus other antihyperglycaemic drugs were included. Data analysis employed the random-effects model, presenting odds ratios (OR) with 95% confidence intervals (CI). Heterogeneity was assessed using I statistics, and a sensitivity analysis was performed to test the result's robustness.
Five observational studies involving 2,500,430 participants met the inclusion criteria. The meta-analysis indicated that GLP-1RA use was associated with a nonsignificant reduction in the incidence of glaucoma (OR: 0.78; 95% CI: 0.60 to 1.02; p = 0.01: I = 88%). Sensitivity analysis by leave-one-out method showed a significant reduction of glaucoma in GLP-1 RA users.
In conclusion, GLP-1RA usage in T2DM patients may be beneficial in lowering the risk of glaucoma under some circumstances. These results advocate for further clinical studies to confirm GLP-1RAs' protective ocular effects, potentially influencing future treatment guidelines and preventive care strategies for glaucoma patients.
青光眼是不可逆失明的主要原因，在2型糖尿病（T2DM）患者中尤为普遍，而T2DM是该疾病的已知危险因素。本系统评价和荟萃分析旨在评估与使用其他降糖药物的患者相比，接受胰高血糖素样肽1受体激动剂（GLP-1RAs）治疗的T2DM患者青光眼的发病率。
截至2024年9月14日，使用MEDLINE（PubMed）、Cochrane图书馆、谷歌学术和Scopus对文献进行了全面检索。纳入了报告使用GLP-1RAs与其他降糖药物的T2DM患者中青光眼发病率的观察性研究。数据分析采用随机效应模型，呈现比值比（OR）及95%置信区间（CI）。使用I统计量评估异质性，并进行敏感性分析以检验结果的稳健性。
五项涉及2,500,430名参与者的观察性研究符合纳入标准。荟萃分析表明，使用GLP-1RA与青光眼发病率的非显著降低相关（OR：0.78；95%CI：0.60至1.02；p = 0.01：I = 88%）。采用留一法的敏感性分析显示GLP-1RA使用者的青光眼显著减少。
总之，在某些情况下，T2DM患者使用GLP-1RA可能有助于降低青光眼风险。这些结果主张进行进一步的临床研究，以证实GLP-1RAs对眼睛的保护作用，这可能会影响未来青光眼患者的治疗指南和预防保健策略。
