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Health Line
3 days ago
- Health
- Health Line
Do GLP-1 Weight-Loss Drugs Cause Vision Loss? What to Know
Studies have linked GLP-1 medications to various eye conditions, some of which may lead to vision loss. Despite these findings, a clear link has yet to be established, and much of the evidence remains inconsistent. People should be aware of potential eye disease and blindness risks when discussing a GLP-1 with their doctor. The debate over whether GLP-1 medications raise the risk of eye conditions that could lead to vision loss continues. Scientists have been closely studying this association as more people turn to these widely prescribed drugs for weight management. Some studies have suggested a link, but the overall evidence has been inconsistent. However, when a potential side effect becomes as serious as vision loss or blindness, even a remote possibility is worth investigating. GLP-1 drugs are a class of medications used to treat obesity and type 2 diabetes that include semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound). They work by mimicking naturally occurring hormones that help regulate blood sugar, promote satiety, and reduce appetite. While GLP-1s are generally well tolerated and offer numerous health benefits — from weight loss and better glucose control to a lower risk of cardiovascular disease — research suggests they could increase the risk of certain serious eye conditions. Previous research has linked GLP-1 drugs to a sudden, vision-threatening condition called nonarteritic anterior ischemic optic neuropathy (NAION) and to 'wet' age-related macular degeneration. The risk of developing these conditions is relatively low. However, they are serious and should be factored into the risk–benefit discussion when considering GLP-1 therapy with a doctor. As a flurry of new research offers a clearer picture of how GLP-1 drugs may affect eye health, Healthline spoke with experts to help break down the findings. GLP-1 drugs and eye disease Three new studies investigated the link between GLP-1s and eye disease, but each employed distinct methods and arrived at different conclusions. A new study compared the effects of semaglutide or tirzepatide with other antidiabetic medications — such as insulin and metformin — on optic nerve conditions, including NAION, in patients with type 2 diabetes. The retrospective cohort study, published on August 11 in JAMA Network Open, included nearly 160,000 patients, evenly split into two groups: one taking GLP-1s and one taking other antidiabetic medications. Over two years of follow-up, those taking a GLP-1 had higher rates of NAION and other optic nerve conditions than those in the comparison group. There were 93 patients with other optic nerve disorders in the semaglutide or tirzepatide group, and 54 patients with these disorders in the comparison group. The study did not specify the types of other optic nerve disorders. 'Newer GLP-1RAs have lots of benefits. This study provides evidence of their potential risks. For each patient, the risk-benefit tradeoff critically depends on a patient's clinical characteristics and their preferences and clinicians' recommendations,' senior study author Rong Xu, PhD, professor and director of the Center for AI in Drug Discovery at Case Western Reserve University, told Healthline. A separate retrospective study, also published in August in the same journal, reached a different conclusion. In a large cohort of patients with type 2 diabetes, researchers found that GLP-1 use was not associated with a higher incidence of NAION but was linked to another eye condition: diabetic retinopathy. During a two-year follow-up, 5,037 patients taking a GLP-1 developed diabetic retinopathy, compared with 4,938 who were not — a 7% increased risk. In a twist, the study found that although there was a small increase in diabetic retinopathy, GLP-1 use appeared to protect against the condition's progression and sight-threatening complications. A subgroup of patients in the study had pre-existing diabetic retinopathy. Those who took a GLP-1 had a lower risk of complications, including progression to proliferative diabetic retinopathy, diabetic macular edema, vitreous hemorrhage, and neovascular glaucoma. They were also less likely to require medical, surgical, or laser treatments for their eyes. Most notably, GLP-1 use was associated with a significantly lower incidence of blindness from any cause. Another study — a meta-analysis and review of 78 trials involving more than 73,000 participants — concluded that semaglutide was associated with an increased incidence of NAION but emphasized that evidence for a causal link remains inconclusive. The review, published on August 14 in JAMA Ophthalmology, found that semaglutide neither increased nor reduced the risk of eye disorders, including diabetic retinopathy. It's important to note that all three studies can only identify correlations and cannot establish that taking a GLP-1 causes these eye disorders. Studies so far have also focused almost exclusively on patients with type 2 diabetes, so it's unclear what effect GLP-1s have on eye conditions in individuals taking them for weight loss. Making sense of GLP-1s and eye health If you're having trouble making sense of what these conflicting findings mean — especially if you already take a GLP-1 or are considering one — you're not alone. Here's a quick summary on GLP-1s and various eye conditions, and what experts have to say about them: NAION NAION causes sudden blindness in one eye, usually after waking, that is caused by a lack of blood flow to the optic nerve. The condition is elusive, and not well understood. The condition is serious, but despite an apparent increased incidence among patients taking GLP-1s, the condition is still uncommon. 'NAION is rare in general,' said Xu. 'For patients with high risk of developing NAION (e.g., those with diabetes, hypertension) who are taking GLP-1RAs, ophthalmologists may increase vigilance,' she said. Linda Lam, MD, MBA, an ophthalmologist with Keck Medicine of USC, who wasn't involved in the research, tells Healthline that it's too early to make a 'definitive connection' between NAION and GLP-1s. 'To make a correlation that GLP-1s cause NAION would be a big leap,' she said. Diabetic retinopathy Diabetic retinopathy is a complication of type 1 and type 2 diabetes that may lead to vision loss. It is the most common cause of preventable blindness in the United States. Though it may seem counterintuitive, antidiabetic medications that improve blood glucose may worsen this condition. 'It's better to be cautious and protective with vision. So, if a patient has started on a GLP-1 and they already have some diabetic retinopathy, I would just have them come in sooner to see their eye care provider,' said Lam. 'Wet' age-related macular degeneration A recent study published in June found that patients with type 2 diabetes who took GLP-1s were more than twice as likely to develop wet AMD as those who did not. Researchers also identified a dose response, meaning that the longer the patients took a GLP-1, the more likely they were to develop the condition. However, there still needs to be more research to substantiate this link. 'We need to have a lot more studies before we can make these cause and effect determinations. But, anyone who has neovascular AMD and is on a GLP-1 needs to be monitored more closely,' said Lam. The bottom line: GLP-1s have many health benefits, and while there is some evidence to support an association between them and serious eye conditions, that link should not be overstated, and must be considered within the greater context of your individual health. Patients with diabetes should get regular eye exams, regardless of whether they are taking a GLP-1, but taking the medication may be one more reason to schedule an exam. 'GLP-1s have potentially good long-term effects for long-term health in patients with diabetes or obesity. But doctors should be much more cautious and aware of visual complications while they're on these medications, especially when their glycemic numbers go down rapidly. The threshold for when to see your eye care provider or retina specialist should be lower,' Lam said.
Fox News
5 days ago
- Health
- Fox News
Popular weight-loss drugs linked to sudden vision loss, research suggests
New research has discovered certain weight-loss medications could be associated with an increased risk of serious eye conditions, and even vision loss. Two studies, published in JAMA, analyzed how semaglutide and tirzepatide — which include popular drugs like Ozempic, Wegovy, Mounjaro and Zepbound — impacted eye health in Americans with type 2 diabetes over a two-year period. One study found a modest risk of developing non-arteritic anterior ischaemic optic neuropathy (NAOIN) – a rare eye condition that can lead to sudden vision loss due to lack of blood flow – in association with semaglutide and tirzepatide. Out of more than 159,000 study participants with type 2 diabetes, 35 developed NAION, compared to 19 people in the comparison group. The Ohio-based researchers also noted an increased risk of developing "other optic nerve disorders," identified in 93 patients. Although the second study did not observe a "statistically significant difference" in NAION in GLP-1 drug users, there was a small increase in diabetic retinopathy, an eye disease that can damage the retina. While individuals with type 2 diabetes on GLP-1s showed a modestly increased risk of diabetic retinopathy, the researchers concluded that fewer patients experienced sight-threatening complications from the disease. "These findings suggest that all patients with type 2 diabetes treated with GLP-1 RAs, regardless of preexisting diabetic retinopathy, should be regularly screened and monitored for potential complications," the study authors concluded. Sue Decotiis, M.D., a medical weight loss doctor in New York City, said she believes more studies are required to confirm the association between these drugs and vision loss, as these studies report some conflicting results. "NAION is a rare condition of the optic nerve that, although serious, has not really been shown to be increased by these studies," Decotiis, who was not involved in the research, told Fox News Digital. "We need more studies for certain." Diabetic patients already face a high incidence of eye disease related to blood flow and nerve damage, the expert noted. "Eye complications are often directly related to the degree or lack thereof of diabetes control." In most cases, GLP-1 drugs reduce the severity of type 2 diabetes, therefore reducing the incidence of eye diseases, Decotiis noted. These drugs have also been shown to reduce the risk of cardiovascular disease, like hypertension, and to improve circulation, which can improve eye health. For diabetics who are starting a GLP-1, Decotiis recommends having an exam done by an ophthalmologist and scheduling follow-up exams throughout treatment. "We should take precaution with methodical ophthalmic care for diabetics on these drugs," Decotiis said. "However, let's not throw the baby out with the bath water." For more Health articles, visit Novo Nordisk, maker of Ozempic and Wegovy, provided the following statement when contacted by Fox News Digital. "Patient safety is a top priority for Novo Nordisk, and we take all reports about adverse events from the use of our medicines very seriously. NAION is a very rare eye disease, and it is not an adverse drug reaction for the marketed formulations of semaglutide (Ozempic, Rybelsus and Wegovy) as per the approved labels in the U.S." "Novo Nordisk, on its part, has conducted an analysis across randomized controlled clinical trials with GLP-1 receptor agonists, including a blinded ophthalmologist evaluation to confirm NAION diagnoses. Our current assessment is that these data do not suggest a causal relationship between GLP-1 RA use and NAION events."
