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SGLT2 inhibitors and retinal vein occlusion

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Retinal vein occlusion (RVO) is the second most common etiology for vision loss

  • RVO exists as 2 subtypes:
    • central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO)
    • BRVO may result from compression of a branch retinal vein by an adjacent arteriosclerosis retinal artery
    • CRVO shows low prevalence compared to BRVO
    • CRVO is associated with a worse visual prognosis
    • CRVO is typically caused by thrombus formation near the lamina cribrosa and frequently leads to devastating complications such as neovascular glaucoma

A meta-analysis suggested that DM is a risk factor for RVO (2)

  • significant association between DM and the risk of RVO (OR = 1.68, 95% CI: 1.43-1.99)
  • subgroup analysis indicated that DM was significantly associated with central RVO (OR=1.98, 95% CI: 1.29-3.03, I2=67.9%), but not significantly associated with branch RVO (OR=1.22, 95% CI: 0.95-1.56, I2=64.1%)

SGLT2 inhibitors and RVO

  • a study found use of SGLT2 inhibitors was associated with an increased risk of retinal vein occlusion vs use of other glucose-lowering drugs (HR 1.264; 95% CI 1.06-1.51); risk was higher in those aged >=60 years and those with eGFR <60 mL/min/1.73 m2
    • found that SGLT2 inhibitors were associated with a significantly increased risk of RVO. Older patients and those with chronic kidney disease were at higher risk for RVO.

Reference:

  • Wang Y, Wu S, Wen F, Cao Q. Diabetes mellitus as a risk factor for retinal vein occlusion: A meta-analysis. Medicine (Baltimore). 2020;99(9):e19319.
  • Lee M et al. Sodium-Glucose Cotransporter 2 Inhibitors and Risk of Retinal Vein Occlusion Among Patients With Type 2 Diabetes: A Propensity Score-Matched Cohort Study. Diabetes Care Jul 2021, dc203133.

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