Ocular disorders during treatment with GLP-1 receptor agonists: a systematic review and meta-analysis of observational studies

Introduction Different observational studies have analyzed the effects of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on the risk of ocular adverse events (AEs). The present meta-analysis aimed to assess the effects of GLP-1 RAs on the risk of ocular AEs, including retinopathy, glaucoma, and non-arteritic anterior ischemic optic neuropathy (NAION). Methods A systematic review and meta-analysis of observational studies was conducted in PubMed, Embase, and Web of Science from 2006 to 2025. Studies involving individuals diagnosed with diabetes and/or obesity and overweight, receiving GLP-1 RAs, and evaluating outcomes related to ocular AEs were included. A random-effect meta-analysis approach was used. This study followed the PRISMA statement. Results A total of 28 observational studies (6 for semaglutide and 22 for all GLP-1 RAs) involving T2DM patients were included. When compared to other antidiabetic treatments, GLP-1 RAs did not increase the risk of developing ocular disorders such as NAION (RR, 1.01; 95% CI, 0.62–1.64; I 2 , 89%), glaucoma (HR, 0.84; 95% CI, 0.71–1.00; I 2 , 91%), and retinopathy (new onset or progression) [(HR, 0.96; 95% CI, 0.85–1.08; I 2 , 91%) (HR, 0.97; 95% CI, 0.83–1.14; I 2 , 65%)]. Conclusion Even if no difference was observed between GLP-1 RAs and other antidiabetic medications for all safety outcomes evaluated, it is optimal to monitor the administration of these molecules. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251080120 , identifier CRD420251080120.