Evidence map›Paper›PMID 41488069›Full record

SynthesisFrontiers in medicine2025

Association of glucagon-like peptide-1 (GLP-1) receptor agonists and diabetic retinopathy (DR) - a systematic review and meta-analysis.

Hassan Alwafi, Sarah Saleh Al-Harbi, Ghada Ahmad Aladwani, Safaa M Alsanosi, Tope Oyelade, Fahd Almalki, Husna Irfan Thalib, Abdallah Y Naser, Manal Z Alfahmi, Basil AlOtaibi and 8 more

Erratum issuedAbstract readSystematic Review
In one paragraph

Synthesis in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors.

Hassan AlwafiDepartment of Pharmacology and Toxicology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
Sarah Saleh Al-HarbiDepartment of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia.
Ghada Ahmad AladwaniDepartment of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia.
Safaa M AlsanosiDepartment of Pharmacology and Toxicology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
Tope OyeladeInstitute for Liver and Digestive Health, UCL Division of Medicine, University College London, London, United Kingdom.
Fahd AlmalkiDepartment of Medicine, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
Husna Irfan ThalibGeneral Medicine Practice Program, Batterjee Medical College, Jeddah, Saudi Arabia.
Abdallah Y NaserDepartment of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan.
Manal Z AlfahmiExecutive Administration of Research and Innovation, King Abdallah Medical City, Makkah, Saudi Arabia.
Basil AlOtaibiIndependent Researcher, Jeddah, Saudi Arabia.
Samra FuadGeneral Medicine Practice Program, Batterjee Medical College, Jeddah, Saudi Arabia.
Mohammed Talha Mohammed ZubairGeneral Medicine Practice Program, Batterjee Medical College, Jeddah, Saudi Arabia.
Abdulelah M AldhahirRespiratory Therapy Program, Department of Nursing, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia.
Widya N InsaniDepartment of Pharmacology and Clinical Pharmacy, Padjadjaran University, Jatinangor, Indonesia.
Abdullah A AlqarniDepartment of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
Jaber S AlqahtaniDepartment of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia.
Deema S AshoorAl-Noor Specialist Hospital, Ministry of Health, Makkah, Saudi Arabia.
Mohammad Saleh DairiDepartment of Medicine, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: Previous studies have shown conflicting results on the relationship between glucagon-like peptide-1 (GLP-1) receptor agonists and diabetic retinopathy (DR). This systematic review and meta-analysis aimed to clarify the association between GLP-1 receptor agonists use and the development or progression of DR. Methods: A comprehensive search of MEDLINE (via OVID and PubMed), Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov was conducted from inception to March 2025. We included randomized controlled trials (RCTs) and observational studies reporting on the association between GLP-1 receptor agonists and DR. Screening, data extraction, and quality appraisal were performed independently and in duplicate. We assessed study quality using the Cochrane risk-of-bias tool for RCTs and the Newcastle-Ottawa Scale for observational studies. Meta-analysis was conducted using Stata 17, following PRISMA and MOOSE guidelines. Results: The search identified 6,922 studies. Of these, 39 articles (24 RCTs and 15 observational studies) met the inclusion criteria and 23 were included in the meta-analysis. The pooled analysis showed that GLP-1 receptor agonists were not significantly associated with the risk of DR compared with comparators (pooled RR = 1.00, 95% CI 0.71-1.43). Subgroup analyses by study design yielded similar non-significant results, with a pooled RR of 0.91 (95% CI 0.73-1.14) for randomized controlled trials and 2.09 (95% CI 0.47-9.19) for observational studies. After excluding studies with a high risk of bias, the pooled estimate remained non-significant (RR = 1.06, 95% CI 0.67-1.67), supporting the robustness of the overall findings. The association remained non-significant when restricted to larger studies (>500 participants; RR = 1.13, 95% CI 0.70-1.84). Conclusion: In conclusions, this systematic review found no significant association between GLP-1 receptor agonists and DR risk, though a non-significant trend toward lower risk was observed in randomized trials. Given the limited number of long-term studies, the current evidence remains inconclusive. Future studies with longer follow-up period are warranted to clarify the long-term ocular safety of GLP-1 receptor agonists. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251007882.

Indexed as

diabetesdiabetic retinopathyGLP-1 agonistmeta-analysisobesitysystematic review

Identifiers

PMID41488069
PMCPMC12756447

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.