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This effect is not only assigned to the GSH layer, but also to the presence of extra hydrate layers in aqueous medium

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In 2025, VMAIL reported that the American Optometric Association (AOA) had released a clinical report by their evidence-based optometry committee warning of some serious ocular complications associated with GLP-1 receptor agonists, including exacerbation of age-related macular degeneration, progression of diabetic retinopathy and the rare but serious onset of NAION