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Recent Research Suggests That Drugs Like Semaglutide and Tirzepatide, Used for Weight Loss and Diabetes, May Increase Risk of “Ocular Ischemic Nerve” and Aggravate Retinal Diseases.
Two new studies conducted in the United States indicate that the use of Ozempic and other drugs in the same class may be related to an increased risk of a rare condition called non-arteritic anterior ischemic optic neuropathy (NAION), also known as “ocular ischemic nerve.” The research analyzed medical records of over 159,000 people with type 2 diabetes over two years.
NAION occurs when there is a sudden reduction in blood flow to the optic nerve, causing sudden and painless vision loss. The condition has no cure and, in about 70% of cases, there is no recovery of vision. Although rare, diabetes patients already have an increased risk of developing the problem.
According to the research, among users of semaglutide or tirzepatide, 0.04% developed NAION, compared to 0.02% in the comparison group. Although the difference is small, the data reinforce the need for monitoring patients using these medications.
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Side Effects Beyond NAION
In addition to the risk of NAION, experts emphasize that drugs in the GLP-1 agonists class, such as Ozempic, may negatively influence cases of diabetic retinopathy, a condition caused by damage to the blood vessels in the retina.
According to researchers, the rapid reduction of blood sugar levels, an expected effect of these medications, can destabilize fragile vessels at the back of the eye and lead to bleeding. However, the studies indicated that, despite this initial risk, patients using GLP-1 experienced fewer serious complications and required fewer invasive treatments for retinopathy compared to users of other diabetes medications.
The European Medicines Agency had already included NAION as a rare adverse effect on the label of medications like semaglutide, estimating a risk of 1 case per 10,000 users.
Counterpoints and Uncertainties in Findings
Interestingly, while one of the studies detected a slight increase in NAION cases, the other found no statistically significant evidence for this association. This discrepancy suggests that more research is needed to confirm or rule out the link between Ozempic and sudden vision loss.
Experts state that, although the incidence is low, the impact for those who develop the condition is severe, highlighting the importance of prevention and early diagnosis. Another point emphasized is the possible relationship of the medications with other optic nerve disorders, not yet specified by the codes used in the analyzed medical records.
Meanwhile, a five-year clinical trial with 1,500 participants is underway to evaluate the long-term effects of semaglutide on eye diseases related to diabetes.
Recommendations for Patients and Doctors
According to the researchers, people with multiple risk factors for NAION, such as sleep apnea, hypertension, and diabetes, should carefully assess with their doctor the necessity of using these medications.
Another anatomical risk factor is known as “congested optic disc,” when the blood vessels at the entry point of the optic nerve in the eye are more compact, favoring obstructions. This detail can be identified in routine ophthalmological examinations.
Even without symptoms, users of Ozempic and similar medications should maintain regular visits with ophthalmologists to detect changes early. Reporting medication use to the doctor is essential for proper follow-up.
Precautions to Reduce Risks
In addition to ophthalmological follow-up, specialists recommend strict control of cardiovascular risk factors, such as cholesterol, blood pressure, and blood sugar, which also impact the health of the blood vessels in the eyes.
“Adherence to treatment for heart conditions is associated with a lower risk of NAION”, researchers emphasize. Patients with heart problems who correctly adhere to medication show lower rates of the disease than those who do not follow treatment.
Treating sleep apnea, combined with maintaining a healthy lifestyle, can help reduce the risk of ocular complications associated with the use of GLP-1 agonists.
The information was released by Science Alert, based on two studies published this week and conducted with data from patients in the United States. The content also included technical details presented by researchers from the Centre for Eye Research Australia and Karolinska Institutet.
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