GLP-1 Analogues: New Warning for Rare Vision Disorder

The Therapeutic Goods Administration (TGA) has released a safety alert regarding the risk of eye disorders with glucagon-like peptide-1 (GLP-1) analogues. These medicines are used in the management of type 2 diabetes mellitus and obesity, and include:

• Dulaglutide (Trulicity^®)
• Semaglutide (Ozempic^®, Wegovy^®)
• Liraglutide
• Tirzepatide (Mounjaro^®)*

*Note: Tirzepatide is a dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 analogue.

Product Information (PI) documents for these medicines have been updated to include a warning regarding the risk of non-arteritic anterior ischaemic optic neuropathy (NAION). This is a rare but serious eye disorder caused by reduced blood flow to the optic nerve. It typically presents with sudden and painless loss of vision in one eye and can result in permanent visual impairment or blindness. Current evidence more strongly supports an association with semaglutide; however, warnings have been added for all agents in the class.

Although the risk of NAION appears to be very low, healthcare professionals should be aware of this emerging safety signal given the increasing use of GLP-1 analogues and the potential severity of the outcome. Patients should be advised to seek urgent medical assessment if they experience any unexplained changes in vision. Suspected cases of NAION should be reported to the TGA to support ongoing safety monitoring.