OPHTHALMIC SAFETY OF SEMAGLUTIDE AND TIRZEPATIDE: AN INTEGRATIVE REVIEW OF OPTIC NEUROPATHY, RETINOPATHY, AND OTHER OCULAR OUTCOMES

Abstract

This article aimed to analyze the scientific evidence regarding the ophthalmic safety of semaglutide and tirzepatide, with emphasis on nonarteritic anterior ischemic optic neuropathy (NAION), diabetic retinopathy, and other ocular outcomes. The methodology consisted of an integrative literature review conducted in the PubMed database, covering publications from 2021 to September 2026. After applying the eligibility criteria, 15 studies were selected, including retrospective cohorts, pharmacovigilance analyses, clinical trials, and case reports. The results revealed heterogeneous evidence, with some studies identifying an association between semaglutide and an increased risk of NAION, although with a low absolute frequency, while others found no statistically significant increase. Regarding retinal alterations, signals of visual impairment and retinopathy were identified, along with possible influences of changes in glycemic control. Additionally, observational studies suggested associations with a lower occurrence of certain age-related ocular diseases. It is concluded that the available evidence does not establish a definitive causal relationship between these medications and the investigated ophthalmic events, highlighting the need for prospective studies to clarify the risks and potential underlying mechanisms.