For People With Diabetes, GLP-1 Drugs May Be Linked to Lower Odds of a Leading Cause of Blindness

For People With Diabetes, GLP-1 Drugs May Be Linked to Lower Odds of a Leading Cause of Blindness

An analysis of more than 300 million medical records found that a worrying signal about the popular drugs reversed once researchers accounted for patients' other health conditions.<_o3a_p>

NEW ORLEANS - As millions of Americans have started taking GLP-1 drugs like Ozempic, Wegovy and Mounjaro to control their blood sugar and lose weight, researchers have been working to answer a nagging question about the medications: What do they do to the eyes? When it comes to age-related macular degeneration, a leading cause of vision loss in older adults, the answer so far has been murky. Some studies have suggested the drugs raise the risk of the disease. Others have pointed in the opposite direction.<_o3a_p>

A new analysis presented this week at the 130th annual meeting of the American Academy of Ophthalmology offers one possible explanation for the contradiction: The people taking these drugs often have other health problems that can also damage the eyes.<_o3a_p>

"Previous publications on its association with macular degeneration have been mixed," said Franklin Ye Ruan, the study's lead author and a medical student at Carle Illinois College of Medicine. "Some studies suggest increased risk, while others show lower risk."<_o3a_p>

The team examined the health records of more than 300 million patients in Epic, the electronic medical records system used by many American hospitals and clinics. About 15 million of those patients had taken a GLP-1 drug, roughly 1.4 million had macular degeneration, and 115,056 had both.<_o3a_p>

At first glance, the numbers looked troubling. "Before accounting for underlying health factors, it looked as if GLP-1s were going to increase the odds of developing macular degeneration by 68 percent," Mr. Ruan said.<_o3a_p>

But the drugs are prescribed largely to people with type 2 diabetes or obesity, who also tend to have high blood pressure and high cholesterol, conditions that can take a toll on the delicate blood vessels and tissue at the back of the eye. When the researchers accounted for diabetes, hypertension or high cholesterol, the pattern flipped: GLP-1 use was associated with lower odds of macular degeneration.<_o3a_p>

The difference was clearest among people with type 2 diabetes. Those taking a GLP-1 drug had about 31 percent lower odds of macular degeneration than people with diabetes who were not on the medication.<_o3a_p>

"We were surprised," Mr. Ruan said. "The original data looked as if GLP-1s were going to increase the odds of developing macular degeneration."<_o3a_p>

Macular degeneration damages the macula, the small central part of the retina responsible for sharp, straight-ahead vision, making it harder to read, drive or recognize faces. Nearly 20 million Americans are estimated to have some form of the disease, and there is no cure, though treatments can slow some forms of it.<_o3a_p>

The new findings arrive amid broader scrutiny of how GLP-1 drugs affect vision. The American Academy of Ophthalmology and the North American Neuro-Ophthalmology Society last month issued a statement, providing additional information and advice to both ophthalmologists and the public on what is known and not known about how these medications affect the eyes.<_o3a_p>

Study Limitations<_o3a_p>

This study has important limitations. Because it relied on medical records rather than a randomized clinical trial, it can show only an association between the drugs and macular degeneration, not that the drugs prevent the disease. And patients taking GLP-1 drugs may differ from other patients in ways that records cannot fully capture.<_o3a_p>

The researchers stressed that more work is needed to determine whether the medications can actually help protect against macular degeneration.<_o3a_p>

"Our hope is that these findings encourage more rigorous studies on GLP-1 medications and macular degeneration, taking other underlying health conditions into account," Mr. Ruan said.<_o3a_p>

For patients weighing the drugs, the researchers advise talking it through with a physician, whether an ophthalmologist, a primary care doctor or an endocrinologist.<_o3a_p>

"GLP-1 medications can have immense benefits for an individual," Mr. Ruan said, "and it's important to discuss all risks and benefits with your doctor."<_o3a_p>

About the American Academy of Ophthalmology<_o3a_p>

The American Academy of Ophthalmology is the world's largest association of eye physicians and surgeons. A global community of 32,000 medical doctors, we protect sight and empower lives by setting the standards for ophthalmic education and advocating for our patients and the public. We innovate and support research to advance our profession and to ensure the delivery of the highest-quality eye care. Our EyeSmart® program provides the public with the most trusted information about eye health. For more information, visit aao.org.<_o3a_p>

<_o3a_p>