Ocular complications associated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) – Clinical evidence and insights

Type 2 diabetes mellitus (T2DM) and obesity are commonly treated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs). However, there have been growing concerns over the possibility that these medications may result in ocular adverse events, such as nonarteritic anterior ischemic optic neuropathy (NAION). Standard clinical care can overlook these potentially fatal adverse effects. The purpose of this review was to compile the most recent data on ocular side effects associated with GLP-1 RA therapy, assess their clinical relevance, and highlight necessary preventative and monitoring measures. A thorough search of the literature was conducted using Medline/PubMed/PMC, Google Scholar, Scopus, Web of Science, and ScienceDirect. Relevant literature, including observational studies, randomized trials, case reports, and pharmacovigilance data, was selected for its discussion of GLP-1 RAs and associated eye-related adverse events. Semaglutide, a GLP-1 RA, has been associated in a number of studies and safety assessments with an increased risk of NAION and the progression of diabetic retinopathy, especially in patients with underlying eye disorders. Findings, however, were mixed because no statistically significant link was found in a number of cohort studies and meta-analyses. The necessity for additional research was supported by data from adverse event reporting systems that showed disproportionality signals. Clinicians should be mindful of the potential ocular hazards associated with GLP-1 RAs, even though these medications remain useful in treating T2DM and obesity. Closer ophthalmologic monitoring may be beneficial for patients with known diabetic eye problems. Further prospective research with well-defined ocular outcomes is required to elucidate these correlations and guarantee the secure administration of GLP-1 RAs.

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Publication Details

Journal
Indian Journal of Ophthalmology
Published
2026-03-12
DOI
https://doi.org/10.4103/ijo.ijo_2659_25
Primary Topic
Intraoperative Neuromonitoring and Anesthetic Effects
Type
article
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article

Ocular complications associated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) – Clinical evidence and insights

Rajkapoor Balasubramanian, Naina Mohamed Pakkir Maideen, Sulthan Al Rashid, Palanisamy Amirthalingam
Indian Journal of Ophthalmology
Intraoperative Neuromonitoring and Anesthetic Effects
article

Ocular complications associated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) – Clinical evidence and insights

Rajkapoor Balasubramanian, Naina Mohamed Pakkir Maideen, Sulthan Al Rashid, Palanisamy Amirthalingam
article en

Abstract

Type 2 diabetes mellitus (T2DM) and obesity are commonly treated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs). However, there have been growing concerns over the possibility that these medications may result in ocular adverse events, such as nonarteritic anterior ischemic optic neuropathy (NAION). Standard clinical care can overlook these potentially fatal adverse effects. The purpose of this review was to compile the most recent data on ocular side effects associated with GLP-1 RA therapy, assess their clinical relevance, and highlight necessary preventative and monitoring measures. A thorough search of the literature was conducted using Medline/PubMed/PMC, Google Scholar, Scopus, Web of Science, and ScienceDirect. Relevant literature, including observational studies, randomized trials, case reports, and pharmacovigilance data, was selected for its discussion of GLP-1 RAs and associated eye-related adverse events. Semaglutide, a GLP-1 RA, has been associated in a number of studies and safety assessments with an increased risk of NAION and the progression of diabetic retinopathy, especially in patients with underlying eye disorders. Findings, however, were mixed because no statistically significant link was found in a number of cohort studies and meta-analyses. The necessity for additional research was supported by data from adverse event reporting systems that showed disproportionality signals. Clinicians should be mindful of the potential ocular hazards associated with GLP-1 RAs, even though these medications remain useful in treating T2DM and obesity. Closer ophthalmologic monitoring may be beneficial for patients with known diabetic eye problems. Further prospective research with well-defined ocular outcomes is required to elucidate these correlations and guarantee the secure administration of GLP-1 RAs.

Indian Journal of Ophthalmology
Mohammed Bin Rashid University of Medicine and Health Sciences (AE), Karpagam Academy of Higher Education (IN), University of Tabuk (SA), Saveetha University (IN)
Good health and well-being
Openalex Percentile: Top 25%
Intraoperative Neuromonitoring and Anesthetic Effects
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