Association of sodium–glucose cotransporter-2 inhibitors and the risk of retinal vascular occlusion: A real-world retrospective cohort study in Taiwan

Tzu Yi Lin, Eugene Yu Chuan Kang*, Shih Chieh Shao, Edward Chia Cheng Lai, Nan Kai Wang, Sunir J. Garg, Kuan Jen Chen, Je Ho Kang, Wei Chi Wu, Chi Chun Lai, Yih Shiou Hwang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

1 Scopus citations

Abstract

Aims: Sodium–glucose cotransporter-2 inhibitors (SGLT2is) are proposed to alleviate the development of inflammatory eye diseases. However, the association between SGLT2i and retinal vascular occlusion remains unclear. Therefore, this study aims to explore the effects of SGLT2i on the incidence of retinal vascular occlusion. Materials and Methods: This retrospective cohort study analysed electronic medical records data from the largest multi-institutional database in Taiwan. Individuals who initiated SGLT2is and dipeptidyl peptidase 4 inhibitors (DPP4is) between 2016 and 2019 were included in our analysis. To conduct a homogenous comparison, inverse probability of treatment weighting with propensity scoring was employed. The primary outcome was retinal vascular occlusion, and the secondary outcomes were retinal vascular occlusion-related complications (macular oedema, vitreous haemorrhage, and tractional retinal detachment) and conditions requiring vitreoretinal intervention (intravitreal injection, retinal laser therapy, and vitrectomy). Results: In total, 12,074 SGLT2i users and 39,318 DPP4i users were included. The incidence rate of retinal vascular occlusion in the SGLT2i and DPP4i groups was 1.2 (95% confidence interval [CI], 0.9–1.4) and 1.6 (95% CI, 1.3–1.8) events per 1000 person-years, respectively, which yielded a subdistribution hazard ratio (SHR) of 0.74 (95% CI, 0.55–0.99). Similar risk reductions were observed in the retinal vascular occlusion-related complications (SHR, 0.76; 95% CI, 0.69–0.84) and conditions requiring vitreoretinal intervention (SHR, 0.84; 95% CI, 0.77–0.94). Conclusions: In this multi-institutional study in Taiwan, SGLT2i use was associated with a reduced risk of retinal vascular occlusion. Further prospective studies are required to ascertain this association.

Original languageEnglish
Article numbere3773
Pages (from-to)e3773
JournalDiabetes/Metabolism Research and Reviews
Volume40
Issue number2
DOIs
StatePublished - 02 2024

Bibliographical note

© 2024 John Wiley & Sons Ltd.

Keywords

  • diabetes mellitus
  • real-world database
  • retinal vascular occlusion
  • sodium–glucose cotransporter-2 inhibitor
  • Humans
  • Dipeptidyl-Peptidase IV Inhibitors
  • Sodium-Glucose Transporter 2 Inhibitors/adverse effects
  • Retrospective Studies
  • Taiwan/epidemiology

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