Associação entre o uso de semaglutida e o risco de retinopatia diabética: uma revisão

Abstract

Objective: To review the literature regarding the association between the incidence of Diabetic Retinopathy (DR) and the use of Semaglutide. Method: This study utilized a systematic literature review methodology, focusing on the results of the SUSTAIN 1 and SUSTAIN 6 trials, as well as articles published between 2020 and 2024 in the PubMed database on the association between diabetic retinopathy and systemic use of semaglutide. Guidelines from the Brazilian Ministry of Health and the Brazilian Diabetes Society were included to support the analysis. Results: An association was identified between the use of semaglutide and an increase in microvascular complications, including a higher incidence of DR, vitreous hemorrhage, and blindness. The review also highlights experimental studies suggesting protective effects of GLP-1 receptor agonists on the retina, although rapid glycemic control may initially worsen DR. The evidence indicates that the use of semaglutide requires caution in patients with DR, with recommendations for ophthalmologic monitoring before and during treatment. Conclusion: Semaglutide is effective in glycemic control and weight reduction in patients with type 2 diabetes, but its rapid action in reducing glycated hemoglobin (HbA1c) may increase the short-term risk of diabetic retinopathy (DR). However, sustained glycemic control may reduce this risk over time. Given the high prevalence and impact of DR, it is essential for patients initiating semaglutide treatment to undergo regular ophthalmologic examinations, particularly those with a history of microvascular complications. Integrated follow-up care involving ophthalmologists and endocrinologists is crucial to optimize therapeutic benefits and ensure the ocular health of these patients.