An analysis of more than 300 million US patient records found lower adjusted odds of macular degeneration among people with type 2 diabetes taking GLP-1 medicines, although other studies have reported no link or increased risk.
A fresh analysis presented to the American Academy of Ophthalmology suggests that among people with type 2 diabetes, use of GLP-1 medicines was associated with lower odds of macular degeneration after researchers adjusted for other health conditions. The finding, drawn from more than 300 million US patient records in the Epic electronic health records system, adds a new layer to a field already marked by mixed and sometimes conflicting eye-health signals around drugs such as semaglutide and tirzepatide.
The academy said the work was led by Franklin Ye Ruan, a medical student at Carle Illinois College of Medicine, and was released ahead of its annual meeting in New Orleans. In the unadjusted data, GLP-1 users initially appeared to have a higher likelihood of macular degeneration, but that pattern reversed once researchers took account of diabetes, high blood pressure and high cholesterol, all of which are common among people using these medicines and are themselves linked to eye disease. The academy said the strongest signal of lower odds was seen in patients with type 2 diabetes.
The result does not settle the question. Johns Hopkins Medicine reported in July that a study of more than 200,000 adults with type 2 diabetes found no statistical link between GLP-1 receptor agonists, including semaglutide, and neovascular age-related macular degeneration, also known as wet macular degeneration. A separate study published in Ophthalmology reached a similar conclusion, finding no significant association between semaglutide and the development of that form of the disease.
Other research points in a different direction. A study summarised by Healthline linked GLP-1 drugs to a higher risk of wet macular degeneration in people with type 2 diabetes, particularly with longer use of semaglutide. Meanwhile, a retrospective cohort study in The American Journal of Medicine found no significant association between GLP-1 receptor agonists and age-related macular degeneration in adults with type 2 diabetes or non-diabetic obesity, and a separate study in Retina reported reduced risk of both nonexudative and exudative disease in people with type 2 diabetes.
For patients, the practical advice remains unchanged: do not stop a GLP-1 medicine without speaking to a clinician, and keep up with eye screening. Age-related macular degeneration damages the macula, the part of the retina responsible for sharp central vision, and warning signs can include blurred or wavy central vision and straight lines that appear bent. People with diabetes are already advised to have yearly dilated eye examinations, which offer a chance to check for diabetic eye disease and discuss any concerns about medications and vision.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
