Ophthalmic Complications Associated With the Antidiabetic Drugs Semaglutide and Tirzepatide

Jan 30, 2025JAMA ophthalmology

Eye Problems Linked to the Diabetes Medicines Semaglutide and Tirzepatide

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Abstract

In 2023, nearly 2% of the US population received a prescription for semaglutide.

Nine patients with ophthalmic complications related to semaglutide or tirzepatide were analyzed.
Seven patients experienced nonarteritic ischemic anterior optic neuropathy.
One patient had bilateral papillitis, and another presented with paracentral acute middle maculopathy.
Atypical features observed included sequential ischemic optic neuropathy and bilateral disc swelling.
The study could not establish a causal link between the drugs and the reported ophthalmic complications.

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IMPORTANCE: Nearly 2% of the US population received a prescription for semaglutide in 2023. There has been a recent concern that this drug and other similar medications may be associated with ophthalmic complications.

OBJECTIVE: To report ophthalmic complications associated with the use of semaglutide or tirzepatide.

DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective case series. All patients were initially seen in a community setting. Patients experiencing an ophthalmic complication in association with the use of semaglutide or tirzepatide were included in this analysis.

EXPOSURES: Patients described were using either semaglutide or tirzepatide.

MAIN OUTCOMES AND MEASURES: Visual acuity and visual field defects.

RESULTS: A total of 9 patients (mean [SD] age, 57.4 [11.6] years; age range, 37-77 years; 5 female [56%]; 4 male [44%]) were included in this study. Seven patients with nonarteritic ischemic anterior optic neuropathy, 1 patient with bilateral papillitis, and 1 patient with paracentral acute middle maculopathy were reported. Atypical features included sequential ischemic optic neuropathy, bilateral disc swelling at presentation, and progressive vision loss.

CONCLUSIONS AND RELEVANCE: In this case series study, it was not possible to determine if there is a causal link between these drugs and the ophthalmic complications reported. In some cases, it is hypothesized that rapid correction of hyperglycemia induced by these drugs, rather than a toxic effect of the drugs, could be associated with the ophthalmic complications reported.

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Ophthalmic Complications Associated With the Antidiabetic Drugs Semaglutide and Tirzepatide

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