A RETROSPECTIVE case series has identified ophthalmic complications in patients using the antidiabetic drugs semaglutide and tirzepatide. The rising use of semaglutide and tirzepatide, prescribed to nearly 2% of the US population in 2023, has raised concerns about potential ophthalmic side effects. This report reviews nine patients from a community setting who developed visual complications while taking these medications.
This analysis included nine patients (mean age 57.4 years; range 37–77 years; 5 female, 4 male). Among them, seven patients were diagnosed with nonarteritic anterior ischemic optic neuropathy (NAION), one with bilateral papillitis, and another with paracentral acute middle maculopathy (PAMM). Atypical presentations included cases of sequential ischemic optic neuropathy, bilateral disc swelling at the time of diagnosis, and progressive vision loss. Although these findings are concerning, they do not establish a direct causal link between the drugs and the observed conditions. Nevertheless, the possibility that rapid correction of hyperglycemia, rather than a toxic effect of the medications themselves, might be implicated in these visual disturbances remains a consideration.
Clinicians should be aware of these potential complications, especially as the use of these antidiabetic agents continues to grow. Monitoring visual health in patients prescribed semaglutide or tirzepatide could be prudent, especially for those reporting visual disturbances. Future studies should focus on investigating the underlying mechanisms and potential risk factors contributing to these findings. Meanwhile, careful consideration of glycemic management and its speed of correction may be essential to mitigate potential risks.
Katrina Thornber, EMJ
Reference
Katz BJ et al. Ophthalmic complications associated with the antidiabetic drugs semaglutide and tirzepatide. JAMA Ophthalmol. 2025;DOI:10.1001/jamaophthalmol.2024.6058.
