What to Expect When You’re Expecting Ocular Complications From GLP-1 RAs

A baseline dilated retinal exam is essential before patients start using these medications.

By: Sarah Fackler, managing editor, Optometric Management

Optometric Management October 10, 2025 Vol 60 (80), Issue October 2025

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A baseline dilated retinal exam is crucial before starting GLP-1 RAs to assess diabetic retinopathy and NAION risk.
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Rapid A1C reduction from GLP-1 RAs may worsen diabetic retinopathy, but this is not caused by the medication itself.
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In the SUSTAIN-6 trial, 3% of semaglutide users developed DR complications compared to 1.8% on placebo.
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Tirzepatide is linked to higher odds of proliferative DR in patients with moderate nonproliferative DR and DME.
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Despite ocular risks, the benefits of GLP-1 RAs in managing diabetes and cardiovascular risks currently outweigh the risks.

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