Glucagon-like Peptide-1 Receptor Agonists and Ocular Disease: Mechanisms, Evidence and Therapeutic Perspectives

Ocular diseases – including glaucoma, diabetic retinopathy, and age-related macular degeneration – remain major global causes of irreversible vision loss. Despite therapeutic advances, current interventions that address the convergent metabolic, inflammatory, vascular and neurodegenerative components of these diseases are limited. Glucagon‑like peptide‑1 receptor agonists (GLP‑1RAs), widely used for type 2 diabetes and obesity, have emerged as multi-target candidates for ocular therapeutics due to their pleiotropic anti‑inflammatory, antioxidant, vasculoprotective, and neuroprotective properties. Increasing preclinical and clinical evidence indicates that GLP‑1RAs preserve blood–retina barrier integrity, inhibit pathological angiogenesis, reduce inflammation, promote antioxidant responses and protect retinal neurons from degeneration. However, rare ocular adverse events – including nonarteritic anterior ischemic optic neuropathy and “early worsening” of diabetic retinopathy – highlight the need for a balanced and comprehensive consideration of evidence. This review synthesizes mechanistic in-sights, experimental findings, clinical data, and safety considerations to critically assess the potential of GLP‑1RAs as disease‑modifying therapeutics for ocular disorders and outlines translational challenges and research priorities to guide future ophthalmology‑focused investigations.