Neuro-Ophthalmologic and Retinal Repercussions Associated with GLP-1 Receptor Agonists
DOI:
https://doi.org/10.5281/zenodo.20149713Keywords:
GLP-1 Receptor Agonists, Diabetic Retinopathy, Ischemic Optic Neuropathy, Ophthalmology, SemaglutideAbstract
GLP-1 receptor agonists have revolutionized the treatment of type 2 diabetes mellitus and obesity due to their metabolic and cardiovascular benefits. However, recent studies have investigated possible neuro-ophthalmological and retinal repercussions associated with these medications, especially semaglutide and tirzepatide. This study aimed to critically analyze the available evidence regarding ocular alterations related to GLP-1 receptor agonists, discussing possible pathophysiological mechanisms, risks, and protective effects described in the literature. This was an integrative literature review conducted in the PubMed, Scopus, and Web of Science databases, including studies published between 2024 and 2026. Six articles were selected after applying the eligibility criteria. Part of the literature identified an association between GLP-1 receptor agonists and an increased risk of nonarteritic anterior ischemic optic neuropathy, diabetic retinopathy, and retinal microvascular alterations. In contrast, other authors reported neuroprotective and anti-inflammatory effects, as well as a potential reduction in glaucoma progression and severe retinal complications. Transient worsening of diabetic retinopathy related to rapid glycemic reduction emerged as an important pathophysiological hypothesis. It is concluded that GLP-1 receptor agonists present complex ophthalmological effects that are not yet fully understood, making regular ophthalmologic monitoring and further prospective studies essential to better define their ocular safety.
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Copyright (c) 2026 Rafael Baís Valente, Gabriela Patricia Burgel Macêdo
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