GLP-1 Receptor Agonists and Eye Health: A Review of Ocular Complications

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a class of medications widely used for managing type 2 diabetes and obesity, known for their efficacy in glycemic control and weight loss. While their systemic benefits are well-established, emerging clinical observations have raised concerns regarding potential ocular complications. This review aims to synthesize the current clinical evidence, explore potential underlying mechanisms, and provide practical recommendations for managing ocular adverse events associated with GLP-1 RA therapy.

The review identified several categories of ocular complications potentially associated with GLP-1 RA use, including the progression of diabetic retinopathy, development of macular edema, and other less common adverse events. While specific incidence rates varied across studies, the collective evidence suggested a need for increased vigilance. The authors proposed several potential mechanisms, such as rapid glycemic control leading to acute changes in retinal hemodynamics, or direct effects of GLP-1 receptors found in ocular tissues. The most significant finding was the consistent identification of diabetic retinopathy progression as a primary concern, particularly in patients with pre-existing retinopathy or those experiencing rapid improvements in glycemic control. The review highlighted that while GLP-1 RAs offer substantial benefits, their use necessitates careful ophthalmic monitoring, especially in vulnerable patient populations.