Popular Diabetes Drug Doubles Risk of an Age-Related Eye Condition

While the relative risk doubled, the absolute risk, however, is still low.

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Millions of Americans taking popular diabetes and weight-loss drugs may face double the risk of developing a vision-threatening eye condition, according to a major new study that tracked more than one million patients for three years.

The Risk in Context

The research, recently published in JAMA Ophthalmology, found that patients taking glucagon-like peptide-1 receptor agonists (GLP-1 RAs)—which include Ozempic, Wegovy, and Rybelsus—had more than twice the risk of developing neovascular age-related macular degeneration (nAMD), also known as “wet” AMD, a leading cause of blindness in older adults.

While the relative risk doubled, the absolute numbers remain small: 0.2 percent of GLP-1 users developed the eye condition compared to 0.1 percent of nonusers over three years. This means roughly 1 in 1,000 additional users might develop the condition. However, with millions of people taking these medications, that could affect thousands of people.

Researchers analyzed health records from Ontario, Canada, involving more than 1.1 million patients 66 and older with diagnosed diabetes, tracking them from January 2020 to November 2023.

The primary outcome was new cases of nAMD, identified through medical billing codes associated with eye injections used specifically to treat this condition. Patients were followed from six months after starting GLP-1 RAs until they developed nAMD, died, or until the end of the study period.

The study found that longer use of GLP-1 drugs led to progressively higher risks of developing wet AMD, suggesting a dose-response relationship.

Patients who used the medications for 6 to 18 months had about double the risk, while those using them for 18 to 30 months saw their risk more than triple. The highest risk was among patients who used the drugs for more than 30 months, who faced nearly four times the normal risk of developing the sight-threatening condition.

Wet AMD is caused by abnormal blood vessels growing under the retina, causing swelling, bleeding, and scarring that can lead to vision loss. It causes faster vision loss compared to the more common “dry” AMD, though the condition is treatable when caught early.

“We have excellent treatment options for neovascular AMD, the most effective being intravitreal anti-VEGF injections, [which block abnormal blood vessel growth],” Dr. James Kelly, owner of Kelly Vision and the director of refractive surgery for all of Northwell Health in New York, told The Epoch Times. These treatments can often stabilize or even improve vision when started early.

Other treatment options, like photodynamic therapy (PDT) and laser photocoagulation, are less commonly used and may be considered for specific situations. 

GLP-1RAs may increase the risk of developing wet AMD by causing rapid reductions in blood sugar, VanderBeek said. This could lead to insufficient oxygen in the retina, which would trigger the production of VEGF, a chemical that promotes abnormal blood vessel growth.

The authors noted that while the study shows an association between GLP-1 RAs and nAMD, it does not establish cause and effect.

“It’s important to highlight that this was a retrospective study, and only showed association and not causation,” Dr. Jovi Boparai, ophthalmic surgeon, co-founder and CEO of CorneaCare, and not involved in the study, told The Epoch Times. The absolute risk remained low.

Should We Be Concerned?

Medical experts stress that patients shouldn’t stop taking these medications without consulting their doctors, as diabetes and obesity carry serious health risks of their own, including diabetic blindness.

VanderBeek noted in the commentary that the findings highlight a “new potential concern” for individuals taking GLP-1 RAs and emphasized the importance of scrutinizing the safety profile of these widely used medications.

“It’s important not to panic,” Meenal Agarwal, an optometrist, host of the podcast “Uncover Your Eyes,” and owner of three eye care practices in Canada, told The Epoch Times.

Agarwal, who was not involved in the study, explained that while the study adds a new consideration to the conversation around GLP-1 receptor agonists, these medications are still effective for managing Type 2 diabetes and obesity, “which are conditions that carry serious risks, including blindness from diabetic retinopathy.”

Agarwal advised those concerned about the study findings to speak with their prescribing physician and have annual exams with their eye doctors. “The goal is not to stop treatment abruptly,” she added, “But to evaluate your overall risk and consider appropriate monitoring.”

NovoNordisk Responds

In an emailed statement, a spokesperson for NovoNordisk, maker of Ozempic and Wegovy, told The Epoch Times that Semaglutide has been extensively examined in “robust” clinical development programs, large real-world-evidence studies, and has, cumulatively, “over 33 million patient years of exposure” and demonstrated improvements in cardiovascular outcomes.

“Novo Nordisk remains confident in the benefit-risk profile of our GLP-1 medicines, when used consistent with their indications and product labeling.”