Sodium-Glucose Co-transporter-2 Inhibition and ocular outcomes in patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.

Sodium-glucose co-transporter 2 (SGLT-2) inhibitors are effective for the treatment of macrovascular complications and nephropathy in type 2 diabetes (T2DM) but effects on microvascular eye outcomes are unclear. We conducted a systematic review and meta-analysis of randomized placebo-controlled trials to evaluate the effect of SGLT-2 inhibition on total ocular events and retinopathy in patients with T2DM. We searched MEDLINE and Embase from database inception date to 11th October 2019. Two reviewers working independently extracted relevant data. Random effects models with inverse variance weighting were selected to estimate summary risk ratios and 95% CIs. We included nine studies, involving 39 982 patients with mean follow-up 2.8 years. There were 1414 total ocular events of which 624 were retinopathy events. SGLT-2 inhibition was not associated with a change in the risk of total ocular events (RR 0.97; 95% CI 0.85, 1.11) or retinopathy (RR 0.98; 95% CI 0.84, 1.16) with consistent effects across studies (P-heterogeneity=0.35 and 0.45, respectively). The effects of SGLT-2 inhibition on eye disease in individuals with T2DM are likely null, though the available data cannot excluded small-to-moderate benefits or harms. This article is protected by copyright. All rights reserved.