The best peptides for eye health, measured by evidence, are two approved drugs: pegcetacoplan (Syfovre), a pegylated cyclic peptide that slowed the growth of geographic atrophy by about 19–22% over 24 months with monthly injections, and cyclosporine eye drops for dry eye.[1][4][8] Investigational peptides such as risuteganib and elamipretide have mixed early results.[5][6] The most talked-about peptide-eye link is a risk: semaglutide is now listed in Europe as a very rare cause of NAION, a sudden optic nerve stroke.[9]
For wider longevity topics, see our longevity peptides hub.
Evidence at a glance
| Peptide or drug | Evidence level | What was shown | FDA status | Our profile |
|---|---|---|---|---|
| Pegcetacoplan (Syfovre) | FDA-approved for this use | 19–22% slower lesion growth at 24 months (monthly, two trials)[1] | Approved for geographic atrophy (2023)[2] | — |
| Cyclosporine eye drops (Restasis) | FDA-approved for this use | Increases tear production in some dry eye[8] | Approved | — |
| Risuteganib | Small human studies | 48% vs 7% gained 8+ letters in a 45-person trial[5] | Investigational | — |
| Elamipretide (SS-31) | Human RCTs (phase 2) | Missed primary goals in dry AMD; phase 3 ongoing[6][7] | Approved only for Barth syndrome | SS-31 |
| Semaglutide | Safety signal | Very rare NAION; retinopathy can worsen with fast glucose drops[9][13] | Approved (not for eyes) | Semaglutide |
| GHK-Cu, BPC-157 | No evidence, marketing only | No human eye-disease trials | Not approved[15] | GHK-Cu, BPC-157 |
Proven eye care comes first
Most vision loss is prevented or slowed by regular eye exams and established treatments, not peptides:
- Routine dilated eye exams, especially for people with diabetes, high blood pressure or a family history of macular degeneration
- Controlling blood sugar and blood pressure, which protects the retina
- AREDS2-formula supplements for people with intermediate macular degeneration; in the AREDS2 trial, lutein and zeaxanthin were a suitable replacement for beta carotene in the original formula[14]
- Anti-VEGF injections for wet macular degeneration and diabetic macular edema, which are proteins, not small peptides
Pegcetacoplan: the approved peptide for geographic atrophy
Geographic atrophy (GA) is the advanced form of dry age-related macular degeneration, in which patches of retina slowly die. Pegcetacoplan blocks complement C3, part of the immune system linked to GA.
What it is. The label describes pegcetacoplan as two identical 15-amino-acid peptides attached to the ends of a polyethylene glycol (PEG) chain.[3] Each peptide is ring-shaped, so reviewers describe it as a pegylated bicyclic peptide.[4] Our cyclic peptides guide explains why rings make peptides more stable.
The OAKS and DERBY trials. These two phase 3 trials enrolled 1,258 people aged 60 and older:[1]
- In OAKS, monthly and every-other-month injections slowed lesion growth by 21% and 16% at 12 months.
- In DERBY, the 12-month reductions (12% and 11%) did not reach statistical significance.
- At 24 months, growth was slowed by 22% (monthly) and 18% (every other month) in OAKS, and by 19% and 16% in DERBY.
- Key vision measures, such as reading speed and sharpness of sight, did not differ from sham at 24 months.
- New wet AMD developed in 11-13% of patients on monthly injections, versus 2-4% with sham.
FDA approved Syfovre on February 17, 2023.[2] The label warns of eye infection, retinal detachment, retinal vasculitis and retinal vessel blockage, intraocular inflammation, a higher chance of developing wet AMD, and raised eye pressure.[3] The drug slows damage; it does not restore lost vision.
What treatment involves. A qualified physician injects 15 mg into each affected eye once every 25 to 60 days. It must not be given to people with an eye or eyelid infection or active inflammation inside the eye. After each injection, report eye pain, redness, light sensitivity or blurred vision without delay, because these can signal a serious infection.[3]
Cyclosporine: a cyclic peptide in eye drops
Cyclosporine is a ring of 11 amino acids, many of them chemically modified.[8] As an eye emulsion, it is approved to increase tear production in people whose tears are reduced by eye inflammation (keratoconjunctivitis sicca). The label notes that increased tears were not seen in people using other anti-inflammatory eye drops or punctal plugs.[8]
Investigational eye peptides
Risuteganib is an integrin-blocking peptide injected into the eye. In a phase 2a trial of 45 people with dry AMD, 48% of the risuteganib group gained 8 or more letters on an eye chart at week 28, versus 7% of the sham group at week 12.[5] The trial was small and compared different time points, so larger trials are needed.
Elamipretide (SS-31) targets mitochondria. In the 176-person ReCLAIM-2 trial, daily under-the-skin injections did not meet either primary goal (low-light vision or GA growth), though a secondary measure of photoreceptor loss looked better.[6] The phase 3 ReNEW trial has 313 participants and is expected to finish in 2027.[7] Elamipretide is approved only for Barth syndrome; see our mitochondrial peptides guide.
Semaglutide and the NAION signal
NAION (non-arteritic anterior ischemic optic neuropathy) is a sudden loss of blood flow to the optic nerve, usually causing painless vision loss in one eye.
- The first alarm (2024): a neuro-ophthalmology clinic study found 17 NAION cases among semaglutide users with type 2 diabetes versus 6 in a comparison group. It was a small, specialist-clinic sample.[10]
- Danish-Norwegian registry (2025): among 61,377 semaglutide users with type 2 diabetes, NAION risk was about 2.8 times that of SGLT2 inhibitor users, or about 1.4 extra cases per 10,000 person-years.[11]
- Europe (2025): EMA’s safety committee concluded NAION is a very rare side effect of semaglutide, affecting up to 1 in 10,000 people, and advised stopping semaglutide if NAION is confirmed.[9]
The June 2026 US Wegovy label we checked does not list NAION but does warn about diabetic retinopathy.[12] In SUSTAIN-6, retinopathy complications were more common on semaglutide (hazard ratio 1.76), mainly in people with existing eye disease whose blood sugar fell quickly.[13] Our GLP-1 and eye health guide covers this in depth.
Unproven “eye peptides”
Copper peptides (GHK-Cu) are sold in eyelash and under-eye products, and BPC-157 is promoted online for eye healing. Neither has human trials for eye disease. FDA lists GHK-Cu (injectable) and BPC-157 among compounding substances whose nominations raised safety concerns.[15] Never put a non-sterile product in or near the eye.
Related longevity reading: thymosin alpha-1 vs LL-37 and peptides vs exosomes.
Questions to ask your eye doctor
- What type and stage of macular degeneration do I have?
- Would pegcetacoplan help, and how often would I need injections?
- Should I take an AREDS2 supplement?
- I take semaglutide; are there signs I should watch for?
