A recent case series has reported nine patients who developed ophthalmic complications while using glucagon-like peptide 1 (GLP-1) receptor agonists semaglutide and tirzepatide. The most common complication was nonarteritic anterior ischemic optic neuropathy (NAION), with seven patients experiencing this condition. Researchers believe that rapid correction of hyperglycemia induced by these drugs may be associated with the eye disorders.
The study, which included six patients taking semaglutide and three taking tirzepatide, found that all patients had a history of type 2 diabetes and other health conditions. Visual acuity measurements and visual field defect assessments were used to evaluate the patients’ vision.
Seven patients developed NAION, with some experiencing atypical symptoms such as sequential ION (increased intraocular pressure) and swelling of the optic nerve head in both eyes. One patient who developed bilateral diabetic papillitis while taking semaglutide did not experience vision loss and continued receiving the medication.
The researchers suggested that rapid correction of hyperglycemia, rather than direct toxicity from the medications, may be linked to the reported ophthalmic complications. The American Academy of Ophthalmology has recommended that patients stop using semaglutide if they experience vision loss, but clinicians should consider a more gradual approach to lowering A1C levels.
With an estimated 30 million GLP-1 RA prescriptions expected to be dispensed in the US by 2030, this study highlights the need for further research on the risk of NAION associated with these medications.
Source: https://www.medscape.com/viewarticle/eye-complications-found-use-semaglutide-tirzepatide-2025a100032f?form=fpf