Vitreous hemorrhage in a patient on tirzepatide: Coincidence or drug induced?

Abstract

Tirzepatide is a synthetic polypeptide classified as glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 receptor agonist. It stimulates insulin secretion from the pancreas and helps lower blood sugar levels in patients with type 2 diabetes mellitus. It also reduces appetite and helps in weight reduction management. We report a case of unilateral vitreous hemorrhage in a middle-aged woman on tirzepatide for weight loss. A 55-year-old female, nondiabetic, on tirzepatide for weight loss presented with sudden visual loss in the right eye while being on tirzepatide. Her ocular history is known for angle-closure glaucoma status postsurgical peripheral iridectomy in both eyes many years back. Her medical history is notable for palpitations and is currently managed with beta blockers. At presentation, the best-corrected visual acuity in the right eye was 0.16 and 1.0 in the left eye. Fundus examination revealed vitreous hemorrhage in the right eye. Vitreous hemorrhage spontaneously resolved and uncorrected visual acuity improved to 1.0 over a period of four months. The key point to be conveyed from this case is the need for more studies into whether there is a causal relationship between tirzepatide and vitreous hemorrhage in nondiabetic patients and to promote caution when administering tirzepatide.