TOPLINE:

The use of GLP-1 receptor agonists was associated with a substantially lower long-term risk for dry age-related macular degeneration (AMD) than the use of other weight-loss medications in adults with overweight or obesity but without diabetes. However, the use of these drugs was not associated with a lower risk for progression to wet AMD in participants already diagnosed with the dry form of the eye disorder.

METHODOLOGY:

• Researchers conducted a retrospective cohort study to compare the risks for dry AMD and its progression to the wet form among patients with overweight or obesity but without diabetes who were prescribed GLP-1 receptor agonists or other drugs for weight loss.
• The analysis included 91,408 patients; after matching propensity scores, 45,704 patients were included in each group. In both groups, about 78% of participants were women, and the mean age was approximately 61 years.
• Patients received liraglutide, semaglutide, or another weight-loss drug such as lorcaserin, sibutramine, setmelanotide, fenfluramine, mazindol, orlistat, phentermine, or diethylpropion.
• For the primary analysis focusing on the development of dry AMD, patients with a history of dry AMD were excluded. For the secondary analysis focusing on progression to wet AMD, patients with dry AMD were included, but those with a history of wet AMD were excluded.
• The primary outcome was assessed at 5, 7, and 10 years, and the secondary outcome was assessed at 10 years only.

TAKEAWAY:

• The use of GLP-1 receptor agonists was associated with significantly lower risks for dry AMD at 5 years (risk ratio [RR], 0.16; P < .001), 7 years (RR, 0.13; P < .001), and 10 years (RR, 0.09; P < .001) than the use of other weight-loss drugs.
• No use of weight-loss medication was linked to a lower risk for dry AMD in the long term than the use of other weight-loss drugs but to a higher risk than the use of a GLP-1 receptor agonist.
• In patients with dry AMD, treatment with GLP-1 receptor agonists was not associated with a lower risk for progression to wet AMD than treatment with other weight-loss drugs.

IN PRACTICE:

The use of GLP-1 receptor agonists “could be considered in counseling patients with elevated AMD risk who are eligible for pharmacologic weight loss,” the researchers of the study reported.

“What perhaps is most striking about this article is the degree of risk reduction of AMD…which was found to be greater than 80% at 5 years and increased with the later timepoints up to 10 years compared with other weight-loss drugs,” experts wrote in an editorial accompanying the journal article.

SOURCE:

The study was led by Abhimanyu S. Ahuja, MD, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon. It was published online on October 23, 2025, in JAMA Ophthalmology.

LIMITATIONS:

Geographic atrophy could not be assessed due to privacy constraints, limiting analysis of rare outcomes. The analysis of progression to wet AMD may have been underpowered due to the smaller cohort size. The study relied on standard diagnostic codes, which were subject to variability in clinician documentation. Adherence to medication could not be assessed because prescriptions alone were used to determine usage.

DISCLOSURES:

The study reported receiving support through an unrestricted grant from Research to Prevent Blindness (Core Grant), New York City, and from the Malcolm M. Marquis, MD, Endowed Fund for Innovation to the Casey Eye Institute, Oregon Health & Science University. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.