GLP-1 medications have become popular as a treatment for weight loss and diabetes. However, some recent studies have raised questions about a possible association between GLP-1 drugs, particularly semaglutide, and ischaemic optic neuropathy, sometimes referred to as an ‘eye stroke.’
A new study published in the British Journal of Ophthalmology found that Wegovy, a GLP-1 receptor agonist, may carry the highest risk among medications in this class.
Ischaemic optic neuropathy (ION) occurs when blood flow to the optic nerve is reduced, resulting in sudden vision loss in one or both eyes.
Although rare, ION has recently been linked to GLP-1 receptor agonists, particularly semaglutide.
To determine whether the risk differed between medications, researchers analysed reports of harmful side effects submitted to the US Food and Drug Administration’s Adverse Event Reporting System (FAERS) from around the world between December 2017 and December 2024.
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The analysis included GLP-1 receptor agonists such as semaglutide (Wegovy, Ozempic, and Rybelsus) as well as tirzepatide (Mounjaro and Zepbound).
Of more than 30.6 million adverse event reports in the database, 31,774 involved semaglutide. The average age of patients in these reports was 56, and 54 per cent were women.
Ozempic generated about seven times more reports, largely because it was approved earlier—in 2017—while Wegovy was introduced in 2021.
Both Wegovy and Ozempic were significantly associated with vision loss. However, the risk appeared nearly five times higher with Wegovy than with Ozempic. The analysis also found that the risk was about three times greater in men than in women.
Researchers suggested that the faster action of injectable drugs and the higher doses used for Wegovy may help explain the stronger association. In contrast, the slower absorption and lower systemic exposure of the oral medication Rybelsus may explain why no clear link was detected.
Another study published last year in JAMA Ophthalmology reported that more than twice as many patients with diabetes taking GLP-1 drugs developed neovascular age-related macular degeneration, a progressive eye disease that can cause vision loss, compared with similar patients who were not using the medication.