Key Takeaways
- GLP-1 and dual-incretin therapies may have both protective and adverse ocular effects, though clinical evidence remains inconsistent.
- Concerns about diabetic retinopathy worsening and possible semaglutide-associated optic neuropathy require further long-term study.
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dual-incretin therapies may have both protective and adverse ocular effects, although current clinical evidence remains mixed, according to a recent review. The therapies, widely used for diabetes and obesity, have been linked experimentally to reduced oxidative stress and neuroprotective effects in retinal and optic nerve tissues.
In diabetic retinopathy, concerns appear to center on transient early worsening related to rapid glycemic improvement rather than direct retinal toxicity. Investigators also noted a potential semaglutide-associated signal for non-arteritic anterior ischemic optic neuropathy, though absolute risk appears low and causality remains unproven.
Emerging studies suggest possible benefits in glaucoma, ocular surface disease, and some retinal vascular outcomes, while evidence for age-related macular degeneration and cataract remains limited or conflicting. The authors note that further prospective studies are needed to clarify long-term ocular safety and identify patients at greater risk for adverse events.
Reference
Lixi F, Troisi M, Calabresi V, et al. Beyond Glycemic Control: Ocular Effects of Glucagon-like Peptide-1 Receptor Agonists. Vision (Basel). 2026 May 14;10(2):29. doi: 10.3390/vision10020029. PMID: 42201157.
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