GLP-1投薬中の患者の眼合併症が神経眼科医を悩ませている(Ophthalmic complications in patients on antidiabetic GLP-1 medications are concerning neuro-ophthalmologists)

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2025-02-05 バッファロー大学(UB)

GLP-1投薬中の患者の眼合併症が神経眼科医を悩ませている(Ophthalmic complications in patients on antidiabetic GLP-1 medications are concerning neuro-ophthalmologists)

バッファロー大学の研究チームは、GLP-1受容体作動薬(商品名:Ozempic、Wegovy、Mounjaro、Zepbound)を服用している一部の患者に、視力低下や視覚障害が報告されていることを明らかにしました。 特に、非動脈炎性前部虚血性視神経症(NAION)と呼ばれる、視神経への血流不足による突然の視力低下が観察されています。この症状は通常、痛みを伴わず、片眼に発生し、視力の永久的な損失を引き起こすことがあります。研究者たちは、GLP-1受容体作動薬とNAIONとの直接的な因果関係はまだ確立されていないとしつつも、これらの薬剤の使用者が増加していることから、医療専門家は患者の視覚症状に注意を払うべきだと指摘しています。特に、これらの薬を服用中の患者が視力のぼやけや喪失を訴えた場合、速やかに眼科医の診察を受けることが推奨されています。

<関連情報>

抗糖尿病薬セマグルチドとティルゼパチドに関連する眼合併症 Ophthalmic Complications Associated With the Antidiabetic Drugs Semaglutide and Tirzepatide

Bradley J. Katz, MD, PhD; Michael S. Lee, MD; Norah S. Lincoff, MD; et al
JAMA Ophthalmology  Published:January 30, 2025
DOI:10.1001/jamaophthalmol.2024.6058

Key Points

Question What are some of the ophthalmic complications that have been observed in patients using the drugs semaglutide or tirzepatide?

Findings In this case series of 9 patients, 7 patients are described with nonarteritic anterior ischemic optic neuropathy, 1 patient is described with papillitis. and 1 patient is described with paracentral acute middle maculopathy. All patients were using either semaglutide or tirzepatide.

Meaning Although a causal link between these drugs and observed complications cannot be established, these findings cannot rule out the possibility that rapid correction of hyperglycemia may be associated with the results reported.

Abstract

Importance Nearly 2% of the US population received a prescription for semaglutide in 2023. There has been a recent concern that this drug and other similar medications may be associated with ophthalmic complications.

Objective To report ophthalmic complications associated with the use of semaglutide or tirzepatide.

Design, Setting, and Participants This was a retrospective case series. All patients were initially seen in a community setting. Patients experiencing an ophthalmic complication in association with the use of semaglutide or tirzepatide were included in this analysis.

Exposures Patients described were using either semaglutide or tirzepatide.

Main Outcomes and Measures Visual acuity and visual field defects.

Results A total of 9 patients (mean [SD] age, 57.4 [11.6] years; age range, 37-77 years; 5 female [56%]; 4 male [44%]) were included in this study. Seven patients with nonarteritic ischemic anterior optic neuropathy, 1 patient with bilateral papillitis, and 1 patient with paracentral acute middle maculopathy were reported. Atypical features included sequential ischemic optic neuropathy, bilateral disc swelling at presentation, and progressive vision loss.

Conclusions and Relevance In this case series study, it was not possible to determine if there is a causal link between these drugs and the ophthalmic complications reported. In some cases, it is hypothesized that rapid correction of hyperglycemia induced by these drugs, rather than a toxic effect of the drugs, could be associated with the ophthalmic complications reported.

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