Vision Loss Linked to GLP-1 Drugs: Study Reveals Three Potentially Blinding Eye Conditions

• Past studies have indicated a potential connection between semaglutide and the condition known as nonarteritic anterior ischemic optic neuropathy (NAION).
• A recent investigatory review highlights nine individuals taking semaglutide and tirzepatide who experienced visual disturbances.
• Three specific, potentially blinding eye conditions highlighted in the study include NAION, papillitis, and paracentral acute middle maculopathy.

According to Bradley Katz, MD, PhD, an ophthalmologist at the John A. Moran Eye Center and professor in the Department of Ophthalmology & Visual Sciences at the University of Utah, it’s crucial for researchers to continue studying the effects of GLP-1 medications on overall health.

Katz stated, “Between 2-3% of the U.S. population received a prescription for one of these medications in 2023. Given the widespread use, it’s vital to monitor any adverse effects on the eye or other parts of the body.”

In this study, Katz and his team focused on nine patients with an average age of 58, comprising five females and four males.

Seven participants developed NAION, a stroke affecting the optic nerve that can cause irreversible vision loss in one or both eyes.

Another patient experienced a stroke in the retina, leading to irreversible vision loss in one eye.

The ninth patient had swelling in both optic nerves but did not lose vision.

The exact cause of these eye issues in GLP-1 users remains unclear, but researchers suspect rapid fluctuations in blood sugar levels may play a role.

Katz explained, “These drugs are effective in reducing blood sugar. When blood sugar drops sharply, it can cause swelling in the optic nerve, potentially leading to these ocular complications.”

The mechanism is believed to involve an osmotic shift, where changes in blood sugar levels affect fluid movement between blood vessels and cells in the eye.

Despite these findings, Katz emphasizes that patients should not discontinue GLP-1 drugs without consulting their healthcare provider.

MNT spoke with Mir Ali, MD, a board-certified general surgeon and medical director of MemorialCare Surgical Weight Loss Center in Fountain Valley, CA, about the study.

“These medications have been used by millions of people for years, and this appears to be a rare complication,” Ali commented. “With such a low occurrence, it’s challenging to establish the exact mechanism behind these eye issues.”

Dr. Howard Krauss, a surgical neuro-ophthalmologist at Providence Saint John’s Health Center in Santa Monica, CA, also weighed in on the study.

Krauss stated, “The proposed mechanisms for these eye injuries warrant further investigation. Annual eye exams are advisable for individuals with underlying conditions that carry a risk of adverse ocular effects.”

“Some individuals may choose to undergo a pre-treatment eye exam to assess ocular health and determine if they have a ‘disc-at-risk’ condition, characterized by a low cup-to-disc ratio, which may increase their likelihood of developing NAION.”

Krauss also suggested evaluating and managing other risk factors, such as sleep apnea, before or during GLP-1 medication therapy.

“Given the widespread use of these medications, maintaining good ocular health and awareness of potential side effects is crucial for patients and healthcare providers alike.”