10/29/2025
Two new studies presented at the annual meeting of the American Academy of Ophthalmology offer mixed results: one found GLP-1 drugs can increase the risk of and non-arteritic anterior ischemic optic neuropathy ( ), while another study suggests the drug may offer protection against dry age-related macular degeneration ( ).
Researchers in an international collaboration across the University of Ottawa Eye Institute, University of Toronto, McMaster University, and Doheny Eye Institute UCLA conducted one of the largest global studies on the topic to date. Using data from the World Health Organization (WHO)'s global database of drug safety reports, the authors analyzed data on 117,173 patients with taking (GLP-1 drugs), , , , or .
Results showed that people using GLP-1 drugs were 68.6 times more likely to develop NAION and eight times more likely to develop diabetic retinopathy than those taking empagliflozin, exenatide, insulin or metformin.
The analysis found no significant association between tirzepatide (the active ingredient in other GLP-1 medications including and ) and NAION or diabetic retinopathy.
In a separate study, researchers at Cleveland Clinic Cole Eye Institute evaluated the effect of GLP-1 drugs on the risk of developing AMD.
Researchers looked at data from more than 430,000 patients aged 50 and older who took either a GLP-1, sodium-glucose cotransporter 2 inhibitors (SGLT2i), or insulin to manage their diabetes for at least two years at a single ophthalmic center. The 7,319 patients taking a GLP-1 for 5 years showed a significantly lower risk of developing dry AMD: 63 percent lower than patients on metformin, 58 percent lower risk than patients on insulin, and 54 percent lower risk than those taking a SGLT2i. The protective effect increased among patients followed for up to five years. The analysis showed no significant protection against the wet form of AMD.
The authors of both studies conclude that more long-term studies are required to determine the effect of GLP-1 drugs on eye health.
So what do physicians and patients do at this time? Based on recommendations from the American Academy of Ophthalmology and the North American Neuro Ophthalmology Society (NANOS), patients who develop NAION while on GLP-1 drugs should engage in a shared decision-making process with their physicians, including their ophthalmologist, neurologist, primary care physician, or endocrinologist. This discussion should consider the individual's overall health, risk factors, and therapeutic options to make an informed decision about whether to continue or discontinue GLP-1 drugs.
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