EC Ophthalmology

Background: Glucagone-Like-Peptide-1 receptor agonists (GLP-1RA) are widely used for diabetes and obesity management, offering significant metabolic benefits. However, recent evidence links these agents to potential ocular adverse events, including vision-threatening conditions.

Objective: To evaluate the nature of ocular adverse events associated with GLP-1RA use. 

Methods: We systematically searched PubMed, Cochrane Library, Web of Science, and Ovid from inception to August 2025 for randomized controlled trials, observational cohorts, and case reports examining ocular outcomes in adults treated with GLP-1RAs.

Results: Evidence for ocular outcomes were mixed. Several trials and database studies reported worsening or progression of diabetic retinopathy, particularly in patients with pre-existing disease and rapid HbA1C reduction, while rare cases of nonarteritic anterior ischemic optic neuropathy were reported. In contrast, some studies suggested protective associations with glaucoma and dry eye disease, whereas findings for age-related macular degeneration were inconsistent.

Conclusion: GLP-1RAs appear to have variable ocular effects, potentially harmful in some conditions yet protective in others. However, high-quality prospective trials are needed to confirm these associations.

 Keywords: GLP-1 Receptor Agonists; Visual Impairment; Ocular Adverse Events; Systematic Review 

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