Watch Out: Ozempic May Increase the Risk of Eye Disease

A recent study published at the Eye Health Experts Conference found that the world’s most talked about diabetic drugs can accelerate the progression of diabetic retinopathy.

Results from the new, unpublished study were presented at the recent annual meeting of the American Retinal Association. They showed that GLP-1 receptor agonists, a drug family including Semaglutide (Ozempic, Rybelsus), Dulaglutide (Trulicity), and Liraglutide (Victoza), increase the risk of developing severe levels of diabetic ocular disease.

Diabetic retinopathy

Diabetic retinopathy is a common complication of type 1 and type 2 diabetes.

The eyes and retina contain many small blood vessels that are very sensitive to hyperglycemia levels. Too much glucose in the bloodstream, a critical feature of diabetes, can cause these small blood vessels to swell and rupture. When it gets worse, the retina begins to grow scar tissue and new dysfunctional blood vessels. Both obscure vision.

Diabetic retinopathy is very treatable – so annual diabetic eye examinations are extremely important, but at worst, the condition can lead to poor vision and even blindness. Early treatment focuses on lifestyle decisions (such as healthy diet and exercise) and optimizing diabetes medications, but if those changes are not sufficient, ophthalmologists can treat their eyes directly with injectable drugs and lasers.

According to the American Diabetes Association, the best way to prevent diabetic retinopathy is to control blood sugar, blood pressure and cholesterol. It is therefore surprising that drugs similar to Ozempic, which have powerful metabolic benefits, may be more likely to develop diabetic retinopathy.

Benefits and Side Effects of Ozempic

Sometimes it may seem like the less true the ozempic (semaglutide) is, the better. Injectables are a game changer for weight loss and are one of the most effective type 2 diabetes medications to date, leading to dramatic improvements in blood sugar, blood pressure and cholesterol levels. Other drugs of the same class, including the GLP-1/GIP receptor agonist tilzepatide (Mounjaro), boast some of the same perks.

However, there is no doubt that Ozempic has many side effects. A very high percentage of users experience some degree of gastrointestinal pain. Other symptoms range from dangerous but rare (including recent reports of gastropia) to purely cosmetics (including hair loss and the so-called “ozenpic face”).

Semaglutide, the active ingredient in Ozempic, is a potent one. It has an impressive effect on risk factors for diabetes, but it is not surprising that several other physical changes may also be involved.

Ozempic and diabetic retinopathy

As reported in Medscape, the new results were presented by Ehsan Rahimy, MD, professor of ophthalmology at Stanford University. Dr. Rahimie shared a top takeout from an unpublished retrospective study of more than 13,500 adults with type 2 diabetes who used either a GLP-1 receptor agonist or an SGLT2 inhibitor. (SGLT2 inhibitors, another class of new diabetic drugs, could have similar effects to GLP-1, including low glucose, weight loss, and cardiac health protection.)

The researchers found that people taking GLP-1 are about 50% more likely to progress to either proliferative diabetic retinopathy (PDR) or diabetic macular edema (DME). It was also likely that interventions such as injections and laser photocoagulation would be required.

This is not the first evidence of the relationship between semaglutide (Ozenpic) and diabetic retinopathy. According to The age of pharmaciesOne of the pivotal studies of semaglutide found an increased risk of diabetic retinopathy, and the US Food and Drug Administration (FDA) reports that a significantly higher proportion of Ozempic users have a DR compared to other GLP-1 receptor agonist users.

The evidence is not unanimous. One large study of Semaglutide has not found such a risk, and another study published at a recent retinal experts’ conference found that albiglutide, previously sold as Tanzeum and became unavailable, is the only GLP-1 receptor agonist that exacerbates diabetic retinopathy.

If the connection is authentic, it seems that the incredible effects of Ozempic can have a negative impact on your eyes. Contrary to all expectations, rapid improvements in glucose control can actually exacerbate diabetic retinopathy. This is called “early worsening.” This is because the eyes get worse before the major long-term benefits of better glycemic control become apparent.

Discussions of the issue by experts from the American Academy of Ophthalmology suggested that the early deterioration from the Ozempics was both “temporary and manageable.” However, experts argue that this effect should be increased scrutiny from ophthalmologists and could seek more aggressive eye health screening.

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Semaglutide (Ozempic), and perhaps other GLP-1 receptor agonists, can exacerbate the eye disease of diabetes and promote the progression of diabetic retinopathy. This appears to occur despite the fact that such drugs usually result in impressive results (including hypoglycemia, weight loss, and improved blood pressure) that should improve eye health.

Experts believe that profit outweighs risks. However, if you are taking Ozempic and have other concerns about the history of diabetic retinopathy and eye health, it may be wise to share your concerns with your doctor or ophthalmologist. They may advise you to schedule a screening for diabetes eye to monitor the impact of your powerful medication on your eye health.