Do GLP-1 Drugs Like Ozempic Cause or Prevent Vision Loss?
Since a study published last year found that patients taking GLP-1 drugs — the active ingredient in Ozempic and Wegovy — may be at higher risk of developing an eye condition that can cause blindness, researchers have been working to learn more about a possible connection to vision loss. Two new studies presented at the annual meeting of the American Academy of Ophthalmology offer mixed results
Researchers in an international collaboration across the University of Ottawa Eye Institute, University of Toronto, McMaster University, and Doheny Eye Institute UCLA conducted one of the largest global studies on the topic to date. Using data from the World Health Organization's global database of drug safety reports, the authors analyzed data on 117,173 patients with diabetes taking semaglutide (GLP-1 drugs), empagliflozin, exenatide, tirzepatide, or insulin.
People using GLP-1 drugs were 68.6 times more likely to develop NAION
Results showed that people using GLP-1 drugs were 68.6 times more likely to develop NAION and eight times more likely to develop diabetic retinopathy than those taking empagliflozin, exenatide, insulin or metformin. The analysis found no significant association between tirzepatide (the active ingredient in other GLP-1 medications including Mounjaro and Zepbound) and NAION or diabetic retinopathy.
“My hope is that these findings empower patients and clinicians to make informed choices among the many GLP-1 receptor agonists now available,” said Moiz Lakhani, a medical student at the University of Ottawa, Faculty of Medicine. “Patients deserve proactive care that includes documenting a baseline eye history, counseling on early visual symptoms, and streamlined referral pathways to ophthalmology, so that emerging issues can be identified and managed without interrupting access to these therapies.”
In a separate study, researchers at Cleveland Clinic Cole Eye Institute evaluated the effect of GLP-1 drugs on the risk of developing AMD.
Researchers looked at data from more than 430,000 patients aged 50 and older who took either a GLP-1, sodium-glucose cotransporter 2 inhibitors (SGLT2i), metformin or insulin to manage their diabetes for at least two years. All patients were seen at a single ophthalmic center, which allowed the authors to manually review all AMD cases identified by ICD-10 coding.
Patients taking a GLP-1 for 5 years showed a significantly lower risk of developing dry AMD
The 7,319 patients taking a GLP-1 for 5 years showed a significantly lower risk of developing dry AMD: 63 percent lower than patients on metformin, 58 percent lower risk than patients on insulin, and 54 percent lower risk than those taking a SGLT2i. The protective effect increased among patients followed for up to five years. The analysis showed no significant protection against the wet form of AMD.
“While the role of GLP-1RA on AMD is still being debated, this study shows a protective effect of GLP-1RA on nonexudative AMD development compared to other antihyperglycemic agents. This study was also the first to investigate the effect of GLP-1 on AMD compared to SGLT2i,” said lead researcher Julia Joo, MD.
The authors of both studies conclude that more long-term studies are required to determine the effect of GLP-1 drugs on eye health. They also endorse the conclusion of both the American Academy of Ophthalmology and the North American Neuro-Ophthalmology Society: Patients who develop NAION while on GLP-1 drugs should engage in a shared decision-making process with their physicians, including their ophthalmologist, neurologist, primary care physician, or endocrinologist. This discussion should consider the individual's overall health, risk factors, and therapeutic options to make an informed decision about whether to continue or discontinue GLP-1 drugs.