TIRZEPATIDE IN MACULAR DEGENERATION: CURRENT EVIDENCE AND CLINICAL PERSPECTIVES

Abstract

Tirzepatide is a dual agonist of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors, initially developed for the treatment of type 2 diabetes mellitus and subsequently incorporated into obesity management. Its metabolic effects—weight loss, improved insulin resistance, glycemic control, and reduction of cardiovascular risk factors—raise the possibility of indirect effects on retinal diseases associated with aging and metabolic changes. However, the relationship between tirzepatide and age-related macular degeneration (AMD) remains far less established than its relationship with diabetic retinopathy. As of 2026, there are no randomized clinical trials demonstrating that tirzepatide directly prevents or treats AMD. Recent literature on GLP-1 agonists suggests a possible association with a lower incidence of AMD, particularly the non-exudative form, but the studies are predominantly observational and offer low certainty of evidence. Concurrently, there are isolated reports of neovascular AMD onset following the initiation of tirzepatide, which do not allow for the establishment of causality. In contrast, recent observational studies specific to tirzepatide have found an association with a lower risk of diabetic retinopathy, diabetic macular edema, and the need for ophthalmic interventions. Thus, tirzepatide should not currently be considered a treatment for AMD, yet it presents a biologically plausible hypothesis regarding retinovascular and neuroinflammatory benefits that warrants prospective investigation.