GLP-1 drugs, like Ozempic, potentially double the risk of eye diseases.
Here's an informal, straightforward, and enriched rewrite of the article:
Title: Warning Bell Tolls for GLP-1 Drugs: Possible Increased Risk of Vision Loss
One in eight people have been reported to have used GLP-1 medications, a rise in popularity due to their effectiveness in treating type 2 diabetes and aiding weight loss. However, recent studies warn of a potential complication—an increased risk of developing a severe eye disease.
Originally developed for type 2 diabetes management, GLP-1 medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) have seeped into the weight loss market. Yet, their usage comes with potential side effects and complications.
Previously, links have been drawn between GLP-1 medications and nonarteritic anterior ischemic optic neuropathy (NAION) and potentially blinding eye diseases. Now, a new study published in the Journal of the American Medical Association reports that older adults with diabetes taking any type of GLP-1 medication may be at a heightened risk for developing neovascular age-related macular degeneration (nAMD).
A Deep Dive into Semaglutide
For this study, researchers analyzed the health records of over 139,000 Ontario residents with an average age of 66 and a diabetes diagnosis, who used GLP-1 medications for at least six months. Rajeev H. Muni, MD MSc FRCSC, associate professor and vice-chair of Clinical Research in the Department of Ophthalmology and Vision Sciences at the University of Toronto, explained that semaglutide represented a whopping 97.5% of the GLP-1 prescriptions in their cohort. Tirzepatide, which had not yet been approved in Canada during the study period, accounted for the remaining 2.5%.
Increased Risk for Vision Loss
The analysis revealed that participants with diabetes taking GLP-1 medications had a two-fold higher risk of developing nAMD, a type of age-related macular degeneration (AMD) that occurs when malformed blood vessels grow underneath the retina, causing fluid leakage in the macula of the eye. Although the absolute risk remains low, this represents a doubling in risk.
Muni emphasized that while the findings should not cause alarm, increased clinical awareness is necessary, as these medications are known for their benefits in cardiovascular, blood sugar control, and weight management. He advises patients, particularly older adults who may be at higher risk for nAMD, to be aware of new visual symptoms and promptly inform their doctors if any changes occur while taking these medications.
Longer Exposure, Higher Risk
Interestingly, the research found a dose-response relationship, with the risk of nAMD increasing as the duration of GLP-1 receptor agonist exposure increased. This suggests that the risk could accumulate over time, requiring further investigation into the long-term ocular safety of GLP-1 drugs.
The study's results should be interpreted cautiously, given its limitations. Critical risk factors like smoking, obesity, and sun exposure were not accounted for in the data. Additionally, the study could be influenced by surveillance bias, and some vulnerabilities in the data may have been faced due to the small number of nAMD events recorded.
Overall, although the absolute risk remains low, the relative increase in the risk of nAMD associated with GLP-1 medications, especially semaglutide, is a significant concern that warrants ongoing monitoring and research. As monitoring eye health is crucial for those on GLP-1 medications, doctors must exercise caution in ensuring their patients' eye health is not compromised, despite the benefits these medications offer. Further studies in various populations and evaluating patients' retina status before starting medication are necessary to gain a clearer understanding of the safety profiles of GLP-1 medications.
[1]: Age-Related Macular Degeneration, American Academy of Ophthalmology, https://www.aao.org/eye-health/diseases/age-related-macular-degeneration-amd
[2]: Macular Degeneration, Diabetes UK, https://www.diabetes.org.uk/diabetes-the-basics/treatment-for-diabetes/managing-diabetes-through-the-years/complications/eye-complications/macular-degeneration
[3]: Ozempic (Semaglutide), Mayo Clinic, https://www.mayoclinic.org/drugs-supplements/ozempic-semaglutide/description/drg-20463756
[4]: Wegovy (Semaglutide), Mayo Clinic, https://www.mayoclinic.org/drugs-supplements/wegovy-semaglutide/description/drg-20463778
[5]: Muni RH, et al. Increased risk of treatment-emergent neovascular age-related macular degeneration in older adults with diabetes using glucagon-like peptide-1 receptor agonists: a nested case-control study using population-based data. JAMA Ophthalmology. Published online December 15, 2022. Doi:10.1001/jamaophthalmol.2022.4663. Accessed December 16, 2022. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2778991
- The potential complications of GLP-1 medications, such as semaglutide and tirzepatide, include an increased risk of developing vision-threatening eye diseases like nonarteritic anterior ischemic optic neuropathy (NAION) and neovascular age-related macular degeneration (nAMD), which could lead to blindness.
- Given the rise in the use of GLP-1 medications for weight management purposes in addition to diabetes treatment, it is important to recognize the increased risk of eye health issues associated with these drugs.
- As GLP-1 medications play a significant role in health and wellness, aspects like weight loss, weight management, and even management of medical conditions like diabetes and fitness, it is essential to conduct further research to understand the long-term ocular safety of these drugs.
- Patients taking GLP-1 medications, particularly older adults, should pay attention to any visual symptoms and collaborate with their medical professionals to ensure proper eye health management alongside the benefits of blood sugar control, cardiovascular health, and potential weight loss.
