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Post hoc analyses of the Trial to Evaluate Cardiovascular and Other Long-term Outcomes With Semaglutide in Subjects With Type 2 Diabetes (SUSTAIN-6) showed an increased risk of diabetic retinopathy complications associated with semaglutide versus placebo among patients with a history of retinopathy, especially among those with insulin use (1). Although concerns have been raised regarding the safety of glucagon-like peptide 1 (GLP-1) receptor agonists in patients with existing retinopathy, subgroup analyses by retinopathy status at baseline have not been presented for other trials of GLP-1 receptor agonists; the two observational studies on GLP-1 receptor agonists and diabetic retinopathy performed to date have excluded patients with a history of retinopathy (2) or treatment of retinopathy (3). We conducted a cohort study (January 2010 to December 2016) of patients with existing retinopathy using …