THE EFFECTS OF GLP-1 RECEPTOR AGONISTS ON OCULAR DISEASES: A NARRATIVE REVIEW

Dawid Gąsowski; Ewa Dapkiewicz; Sylwia Haba; Maria Bołoz; Alicja Smolińska; Jan Szewczyk; Izabela Grzyb; Zuzanna Wątek; Katarzyna Łysynkiewicz; Patrycja Krawczyk

doi:10.31435/ijitss.3(51).2026.6144

Authors

Dawid Gąsowski Independent Public Healthcare Centre in Łapy, Łapy, Podlasie, Poland https://orcid.org/0009-0006-9574-584X
Ewa Dapkiewicz Independent Public Health Care Institution of the Ministry of the Interior and Administration in Białystok, Białystok, Podlasie, Poland https://orcid.org/0009-0000-2148-3484
Sylwia Haba University Clinical Hospital of Białystok, Białystok, Podlasie, Poland https://orcid.org/0000-0001-8396-5948
Maria Bołoz Śniadecki Voivodeship Hospital in Białystok, Białystok, Poland https://orcid.org/0009-0009-9200-0342
Alicja Smolińska Polish Red Cross Maritime Hospital, Gdynia, Pomerania, Poland https://orcid.org/0009-0004-1800-8825
Jan Szewczyk Polish Red Cross Maritime Hospital, Gdynia, Pomerania, Poland https://orcid.org/0009-0003-6214-5192
Izabela Grzyb Polish Red Cross Maritime Hospital, Gdynia, Pomerania, Poland https://orcid.org/0009-0001-7861-4585
Zuzanna Wątek Jędrzej Śniadecki Voivodeship Polyclinic Hospital, Białystok, Podlasie, Poland https://orcid.org/0009-0001-3486-9113
Katarzyna Łysynkiewicz Jędrzej Śniadecki Voivodeship Polyclinic Hospital, Białystok, Podlasie, Poland https://orcid.org/0009-0004-2097-722X
Patrycja Krawczyk Voivodeship Polyclinic Hospital, Kielce, Świętokrzyskie, Poland https://orcid.org/0009-0001-0536-4570

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.6144

Keywords:

GLP-1 Receptor Agonists; Semaglutide; Tirzepatide; Diabetic Retinopathy; Glaucoma; Non-Arteritic Anterior Ischemic Optic Neuropathy; Age-Related Macular Degeneration; Ocular Complications

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are incretin-based agents widely used in the management of type 2 diabetes mellitus and obesity. Beyond their metabolic effects, accumulating evidence indicates that these drugs may significantly influence ocular tissues, potentially exerting neuroprotective and anti-inflammatory actions, while also raising concerns regarding retinal and optic nerve complications.

Aim: The aim of this narrative review was to summarize the current evidence on the effects of GLP-1RAs on ocular diseases, with particular emphasis on diabetic retinopathy, glaucoma, age-related macular degeneration, cataract, non-arteritic anterior ischemic optic neuropathy, and other visual disturbances.

Methods: A structured literature review was conducted using PubMed and Google Scholar. Cohort studies, systematic and narrative reviews, case reports, pharmacovigilance analyses, and preclinical investigations published up to May 2026 were analyzed.

Results: Experimental data suggest anti-inflammatory, antioxidant, vascular, and neuroprotective effects of GLP-1RAs on ocular tissues. Clinical studies report possible benefits in glaucoma and age-related macular degeneration, whereas findings in diabetic retinopathy remain inconsistent. Reported adverse events include transient worsening of diabetic retinopathy, blurred vision, cataract, and possible semaglutide-associated non-arteritic anterior ischemic optic neuropathy. These outcomes may be influenced by rapid HbA1c reduction, weight loss, baseline ocular disease, and vascular risk factors.

Conclusions: GLP-1 receptor agonists may exert both protective and adverse ocular effects. Further prospective studies are required to determine their long-term ophthalmic safety and clinical significance.

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