Diabetes Drug Semaglutide Linked to Vision Loss Risk

A large-scale study published in JAMA Network Open has found that certain widely prescribed diabetes medications may significantly raise the risk of a potentially blinding eye condition in older adults. The drugs in question, known as glucagon-like peptide-1 receptor agonists (GLP-1 RAs), include popular names like semaglutide (Ozempic, Wegovy) and lixisenatide (1^✔ ✔Trusted Source
Glucagon-Like Peptide-1 Receptor Agonists and Risk of Neovascular Age-Related Macular Degeneration

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Over 1 Million Patients Studied

The research team identified 1,069,140 eligible patients between January 2020 and November 2023. Among them, 72,755 patients (6.8%) had been exposed to GLP-1 RAs for at least 6 months, while 996,385 patients (93.2%) had no prior exposure.

Using a 1:2 propensity score matching strategy to reduce confounding factors, the authors created a final matched cohort of 139,002 patients, comprising:

• 46,334 GLP-1 RA users
• 92,668 non-users (controls)

The average patient was 66 years old, and nearly 47% were women. Semaglutide was the most commonly used GLP-1 RA, accounting for 97.5% of prescriptions.

A Doubling of Risk for Wet AMD

Over the course of approximately 2.4 years of follow-up, 93 patients (0.2%) in the GLP-1 RA group developed neovascular age-related macular degeneration (nAMD), also known as wet AMD. In contrast, only 88 patients (0.1%) in the non-user group developed the condition.

This means that patients with diabetes who used GLP-1 RAs had more than twice the hazard of developing wet AMD compared to non-users, even after accounting for age, sex, comorbidities, and socioeconomic factors.

What Is Wet AMD?

The Most Vision-Threatening Form of Macular Degeneration

Wet AMD is a chronic eye disorder where abnormal blood vessels grow under the retina and leak fluid or blood, damaging the macula- the part of the eye responsible for central vision. It can progress quickly and is a leading cause of vision loss in adults over 60.

While there are treatments to slow the disease, early detection is critical. The condition often begins silently, making it vital to understand and monitor for possible risk factors, especially those introduced by medications.

Why This Matters for Patients and Doctors

GLP-1s: Game-Changing but Not Risk-Free

GLP-1 receptor agonists have rapidly become a cornerstone in the treatment of type 2 diabetes and obesity, and have also shown cardiovascular benefits. But as their use has expanded into younger populations and for weight loss, long-term safety data, especially for the eyes, remain limited.

This study is one of the first large-scale human investigations to explore a potential retinal side effect of these drugs.

Interestingly, the increased risk was not associated with other eye diseases, nor was it driven by lixisenatide specifically, suggesting a possible class-wide effect, predominantly tied to semaglutide.

Additional Risk Factors

Age and Stroke History Also Matter

Beyond GLP-1 RA exposure, the study also found that older age and a history of cerebrovascular accident (stroke) were independently associated with a higher risk of developing wet AMD. These findings highlight the importance of considering the entire patient profile when prescribing such medications.

This study does not suggest that patients should stop using GLP-1 drugs. These medications continue to offer tremendous benefits for blood sugar control, heart protection, and weight loss. But like any treatment, they come with potential risks.

If you or a loved one is taking semaglutide or a related GLP-1 RA, especially at an older age, it’s wise to:

• Schedule regular retinal check-ups
• Report any new visual symptoms promptly
• Discuss your personal and family eye health history with your doctor

Ongoing research will help clarify whether this link is causal and if certain populations are more vulnerable than others. For now, both patients and providers should stay informed and proactive.

If you’re on GLP-1 medications and over 60, don’t wait for symptoms. Talk to your doctor about scheduling an eye exam—it might save your sight.

Reference:

1. Glucagon-Like Peptide-1 Receptor Agonists and Risk of Neovascular Age-Related Macular Degeneration - (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2834964)

Source-Medindia