New real-world data unveiled during the American Academy of Ophthalmology (AAO) annual meeting discussed the potential connection between semaglutide, a popular medication for diabetes treatment, and the development of vision loss in patients has uncovered surprising findings.
Give me some background first.
Semaglutide is the active ingredient in Ozempic (Novo Nordisk), which was FDA approved in 2017 with an indication for the treatment of adult patients with type 2 diabetes mellitus.
Per its prescribing info, the drug is a weekly injection with an initial dose of 0.25 mg that can be increased to 0.5 mg or 1 mg, depending on a patient’s individual needs.
How does semaglutide impact it?
When injected, semaglutide releases a hormone (GLP-1) that can signal the body to release more insulin (reducing blood sugar) and potentially cause a full feeling while eating (leading to weight loss, which the FDA also recently approved semaglutide as an indication).
However, with that change in blood sugar, the shape of the eye’s lens can also be affected—leading to blurry vision, according to the American Academy of Ophthalmology (AAO).
Another potential side effect with significant implications: vision loss.
Go on …
Prior research has suggested that a drop in blood sugar (glucose levels) may be connected to a worsening risk for diabetic retinopathy (DR).
However, “while the increased risk is temporary and often manageable with current treatment protocols, this paradox warrants increased attention from ophthalmologists,” the AAO stated.
Which brings us to this research.
Now talk about the study.
Investigators sought to determine this potential cause and effect by using the AAO’s Intelligent Research in Sight (IRIS) Registry to examine data from 48,000+ adults who were:
- Ages 51 to 75 years
- Diagnosed with type 2 diabetes
- Treated with an injectable semaglutide between 2013 and 2021.
Findings?
Following 2 years of treatment, the investigators noted that:
- 2.2% of eyes with no or background DR experienced a worsening of DR.
- 3.5% of eyes with early-stage (mild or moderate nonproliferative DR [NPDR]) disease illustrated a worsening of DR,
- Nearly 60% of eyes with severe NPDR or PDR experienced DR improvement
Any limitations to note?
Lead researcher Zeeshan Haq, MD, noted a few significant limitations:
- Retrospective observational design
- Lack of a control group
- Lack of pre- and post-initiation of semaglutide comparisons
And expert input?
Dr. Haq stated that the results are promising for patients with diabetes looking to use semaglutide for weight loss and other health benefits.
Click here to view Dr. Haqu’s AAO 2023 presentation: Changes in Diabetic Retinopathy After Initiation of Semaglutide (available for attendees via the AAO app).
I’m sensing a but …
Yup. Dr. Haq also recommended that additional research is needed, specifically into the impact of semaglutide on the short- and long-term outcomes in potentially high-risk patients (severe NPDR or PDR).
“Ultimately, diabetic patients who are considering semaglutide should consult with their primary and eye care providers regarding their individual situation,” Dr. Haq stated.
So what’s next?
According to the AAO, a prospective clinical trial called FOCUS is planned to examine the long-term effects of semaglutide as well as diabetic medication on DR.
The FOCUS study is slated to conclude in February 2027.
The American Academy of Ophthalmology annual meeting is being held Nov. 3-6 2023, in San Francisco, California.