Ophthalmic complications observed in patients taking semaglutide and tirzepatide

Bradley J. Katz, MD, PhD, and colleagues reported that ophthalmic complications were observed in patients taking drugs prescribed to treat diabetes, specifically, semaglutide and tirzepatide, although a causal relationship could not be established.¹

Katz is the first author of the study and is from the John A. Moran Eye Center, Department of Ophthalmology & Visual Sciences, Department of Neurology, University of Utah Health, Salt Lake City.

The rationale for the study, according to the authors, is that “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.”

In light of this, Katz and colleagues conducted a retrospective case series that included patients who had been evaluated initially in a community setting. The analysis included patients with an ophthalmic complication in association with the use of semaglutide or tirzepatide, they explained

The main outcomes were the measurements of the visual acuity and visual field defects.

Study identifies ocular findings

The analysis included 9 patients (5 women; mean age, 57.4 years; age range, 37-77 years). Of the 9 patients, 7 patients had nonarteritic ischemic anterior optic neuropathy and 1 patient each had bilateral papillitis and paracentral acute middle maculopathy. The reported atypical features included sequential ischemic optic neuropathy, bilateral disc swelling at presentation, and progressive vision loss.

The investigators commented, “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.”

Reference

1. Katz BJ, Lee MS, Lincoff NS, et al. Ophthalmic complications associated with the antidiabetic drugs semaglutide and tirzepatide. JAMA Ophthalmol. Published online January 30, 2025. doi:10.1001/jamaophthalmol.2024.6058