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Susan Mollan, a consultant neuro-ophthalmologist at the University Hospitals Birmingham in the United Kingdom, wrote in an email that past trials in people with diabetes have shown that when a patients blood sugar control is tightened, they may have a paradoxical worsening of their diabetic retinopathy (temporarily), so its plausible that the GLP-1 drugs, which also help control blood sugar, could have a paradoxical biological effect. Mollan wrote an editorial that was published alongside the new study

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Individual variation in metabolism means some patients clear it faster

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Often better tolerated options include: half-caffeinated coffee tea instead of coffee cold brew in smaller amounts lower acidity options Energy drinks may worsen symptoms

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The answer is straightforward: if a medication is safe and effective for a condition, off-label prescription is standard medical practice

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