FDA warns of rare eye condition linked to some GLP-1 medications

Welcome back. The FDA is requiring new warnings about a rare eye condition that can cause sudden vision loss, and it's linked to certain GLP-1 medications. So it's raising questions about those potential impacts on your vision and how concerned patients should be. We're talking more about this with Dr. Manjot Gill, an ophthalmologist with Northwestern Medicine this morning. Doctor, thanks for joining us. Good morning. Thank you so much for having me. All right. So let's start here. Can you just explain what this eye condition is and how it impacts someone's vision? Yes. So this is referred to as non-arteritic ischemic anterior optic neuropathy. And essentially what this is, is like a stroke to the optic nerve, which is the cable that carries information to and from the eye. Okay, so when I was reading about this this morning, I was reading that the study published here, it tracked 175,000 diabetic patients who were on a semi-glutide and then an equal number of people who were on a non-GLP-1. So is this warning? And I'm asking this, I know a lot of diabetics are on this medicine, but let's be honest, like med spas are prescribing this. People can get this from telemedicine. Is this a warning for everyone that everyone should be concerned of? Or is there something there with the fact that someone is diabetic and then we're seeing these side effects? So I do feel that this warning should be applicable to all patients who are taking GLP medications. Certainly, those patients who are diabetic, have high blood pressure, maybe obese, and have other risk factors such as smoking, sleep apnea, are likely at increased risk because these are the same population of patients who are at risk of this ischemic event or this stroke-like event occurring in the first place. So, I do feel that this risk and warning should apply to all patients who are taking GLPs. Okay, so there is this risk here, but can we talk about how common this condition could be? How concerned should people be taking these medications? So overall, I think the important thing to remember here is that the risk of this complication in the general population is very low. It's cited as somewhere between 2 to 10 per 100,000. And what has been reported in the literature and what the FDA found after reviewing a series of randomized controlled trials is that that risk increased to roughly 6.4% In patients taking the GLPs compared to 3.8 per 100,000 in those not taking GLPs. So although the risk did increase, somewhat less than double. The overall risk is still very, very small if we think about it in absolute numbers. Okay. Okay. So there is still a small risk, but there is a risk nonetheless. A lot of this sounds really, I mean, as you mentioned, it sounds very sudden. Is there anything that people who are taking these medications, is there anything they can do right now to perhaps lessen their risk of getting this? Is it like a food thing? Is it a hydration thing? Is there anything we can do? So that's the thing. I don't think we really fully understand exactly what the cause of this increased risk is. And I would caveat this by saying that this is a potential increased risk. It's an association that's been found, not a definitive causation. And there have been a variety of proposed mechanisms for why this may be taking place. It may be the rapid reduction in blood pressure and decrease in blood flow to the optic nerve. That may be causing this stroke-like event. So that's not entirely clear. I think the important takeaway is just for patients and their providers to be aware of this potential for vision loss. And if patients were to have a sudden, painless decrease in vision, to not ignore it and to report it to their primary care provider and to their eye care provider immediately. So that they can be evaluated. Okay. And that was actually my next question is this sounds like something you also need to be telling your eye doctor that you're probably on these drugs. When you go to the eye doctor, is that the only symptom? What are the symptoms here? Your eyes are getting worse or is this just really sudden? Yes, so this is typically in a classic presentation, it is a sudden decrease, painless loss of vision. It also could be a field of the vision that goes missing. Patients may notice color changes, blurriness in the center vision. So I would say any sudden change in the vision would be worth reporting to your eye doctor as well as to your primary care physician. Doctor, this is fantastic information and it's really important information as well because we know a lot of folks using these drugs at this point. Thank you for being with us this morning. Thank you for having me. Absolutely.