The following is a summary of “Sodium-glucose cotransporter 2 inhibitors and glaucoma in patients with type 2 diabetes,” published in the November 2024 issue of Ophthalmology by Eng et al. 

Researchers conducted a retrospective study to examine the link between sodium glucose co-transporter 2 inhibitors (SGLT2i) use and glaucoma risk in patients with type 2 diabetes mellitus.  

They included adults with type 2 diabetes in the United States who newly initiated treatment with SGLT2i, dipeptidyl peptidase 4 inhibitors (DPP4i), or glucagon-like peptide-1 receptor agonists (GLP1RA) between 2013 and 2023. After propensity score matching, 722,446 patients were included in the SGLT2i and DPP4i arms. Participants were matched based on age at index, race and sex, comorbidities, and concomitant use of medications.  

The results showed that patients using SGLT2i had a lower risk of developing glaucoma compared to those on DPP4i [HR]: 0.815, 95% [CI]: 0.794, 0.837). This included a reduced risk for open-angle glaucoma (HR: 0.755, 95% CI: 0.729, 0.781) and primary angle-closure glaucoma (HR: 0.592, 95% CI: 0.540, 0.650). Among SGLT2i, ertugliflozin was associated with the lowest risk of glaucoma (HR: 0.668, 95% CI: 0.512, 0.871), followed by empagliflozin (HR: 0.727, 95% CI: 0.696, 0.759) and dapagliflozin (HR: 0.814, 95% CI: 0.774, 0.855). The protective effect of SGLT2i on glaucoma remained significant when compared with GLP1RA (HR: 0.932, 95% CI: 0.906, 0.959).  

Investigators concluded that SGLT2i use, particularly ertugliflozin, and empagliflozin, was related with a lower risk of incident glaucoma compared to DPP4i, with a less robust but significant association observed when compared to GLP1RA.  

Source: ajo.com/article/S0002-9394(24)00506-3/abstract