A recent study published in JAMA Ophthalmology underscores the potential vision risks associated with GLP-1 medications, commonly prescribed to individuals with type 2 diabetes. The study highlights several cases of nonarteritic anterior ischemic optic neuropathy (NAION), also known as "eye stroke," among patients taking semaglutide and tirzepatide. These drugs, marketed under brand names such as Ozempic, Wegovy, Mounjaro, and Zepbound, have raised concerns about optic nerve-related complications.
NAION was the most frequently observed condition in the study. This painless disorder typically affects individuals in their 50s and 60s, although younger patients can also experience it. It is characterized by optic nerve swelling, which is visible to eye doctors. Fortunately, this swelling usually subsides within six weeks.
The study summarized vision problems encountered by nine individuals with type 2 diabetes, who were on either semaglutide or tirzepatide. Among these cases, seven individuals suffered from NAION, while one experienced papillitis—an inflammation of the optic nerve—and another developed paracentral acute middle maculopathy, a condition that might result in blind spots. Notably, some patients with NAION reported symptoms between three and 16 months after initiating GLP-1 therapy.
"This review was not conducted in any way that we can say these drugs caused the complications," – Bradley J. Katz, MD, PhD
Patients with type 2 diabetes taking GLP-1 medications are at an increased risk for optic nerve swelling or NAION. This risk is particularly prevalent among those with high blood pressure, high cholesterol, and those who smoke. Typically, NAION occurs in one eye and is often noticed upon waking.
"Most patients lose about half of their peripheral vision in a typical situation," – Bradley J. Katz, MD, PhD
The findings of this study emphasize the importance of monitoring vision changes in individuals using GLP-1 drugs. As optic nerve swelling is a key indicator, regular eye check-ups are crucial for early detection and management of potential complications.
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