Does Ozempic Cause Macular Degeneration? GLP-1 Drugs and AMD Risk Evidence

In 2025 a large Canadian study linked semaglutide and other GLP-1 drugs to roughly double the risk of wet (neovascular) age-related macular degeneration, a leading cause of vision loss in older adults.^[1] The headlines that followed made many patients worry about their eyes. Since then, at least five larger or differently designed studies have looked again. Most found no increased risk of wet AMD,^[2][7] and several found a lower risk of dry AMD in GLP-1 users.^[3][4] All of this evidence is observational. Here is what each study found and how to make sense of the conflict.

The short answer

• One study found a higher risk of wet AMD. In Ontario adults aged 66 and over with diabetes, GLP-1 use was linked to an adjusted hazard ratio of 2.21. The absolute numbers were small: 0.2% vs 0.1%.^[1]
• Larger studies since then haven't confirmed it. In 5.6 million matched US patients with diabetes, GLP-1 use was “not associated with an increased hazard” of wet AMD (HR 1.00).^[2] A 12-database network of semaglutide users with diabetes found “no evidence” of increased or decreased risk.^[7]
• Dry AMD may be less common in GLP-1 users. Several studies found lower rates of dry (nonexudative) AMD, in people with and without diabetes.^[3][4]
• The evidence is weak overall. A 2026 systematic review rated certainty “very low” for all AMD outcomes.^[5]

Wet vs dry AMD

Age-related macular degeneration damages the macula, the center of the retina used for reading and recognizing faces. Most people have the dry (nonexudative) form, which usually progresses slowly. The wet (neovascular, or exudative) form involves abnormal blood vessels leaking under the retina. It can cause faster vision loss and is treated with eye injections. The studies below often report the two separately, and the results differ by type.

The 2025 study that raised the concern

Shor and colleagues used Ontario health records to compare 46,334 adults aged 66 and over with diabetes who took a GLP-1 drug for at least six months with 92,668 matched adults who did not. Over three years, wet AMD was more common with GLP-1 exposure: 0.2% compared with 0.1%, an adjusted hazard ratio of 2.21 (95% CI 1.65–2.96).^[1] The relative increase looked large, but the absolute difference was about 1 extra case per 1,000 people, and the study could not rule out that people prescribed GLP-1s differed in other ways, such as diabetes severity.

What the newer studies found

The largest study, in Epic's Cosmos database, matched more than 5.5 million patients with diabetes. GLP-1 use was linked to a lower hazard of any AMD (HR 0.84) and “was not associated with an increased hazard of nAMD (HR, 1.00).” An independent University of California cohort found the same pattern.^[2] A network of 12 databases comparing semaglutide with dulaglutide, empagliflozin, sitagliptin and glipizide found “no differences in the risk of NVAMD associated with semaglutide use among adults with T2D.”^[7]

For people without diabetes, the data are newer. In adults aged 60 and over with obesity, GLP-1 users had a lower risk of AMD than users of other weight-loss medicines (HR 0.82). The authors note that whether this reflects “direct GLP-1RA neuroprotective mechanisms, greater weight-loss magnitude or both remains to be determined.”^[6] Another study comparing GLP-1s with other weight-loss drugs found less dry AMD (HR 0.47) and no difference in wet AMD.^[4]

Why the studies disagree

A 2026 systematic review examined eight observational studies. It found that GLP-1 use was associated with less dry AMD across diabetic and nondiabetic groups, while results for wet AMD were “heterogeneous: most studies reported neutral or protective associations, whereas one population-based cohort of older adults with diabetes observed an increased risk.” It rated the overall risk of bias as moderate to high and the certainty of evidence as “very low.”^[5]

The studies differ in who was included (older adults with diabetes vs younger people with obesity), what GLP-1 users were compared with (no GLP-1, metformin, or other weight-loss drugs), and how AMD was identified (diagnosis codes vs codes plus eye-injection procedures). Each of these can shift results. A definitive answer would need a trial with planned eye exams, which hasn't been done.

What to do if you take a GLP-1

• Don't stop your medicine over AMD fears without talking to your prescriber. The weight of current evidence does not show increased wet AMD risk.
• Keep up regular eye exams, especially if you are over 60, have diabetes, or already have early AMD.
• Report new vision symptoms quickly, such as wavy lines, a dark or empty spot in the center of your vision, or sudden blurring.
• Know the other eye questions. Diabetic retinopathy and a rare optic-nerve problem called NAION have been studied separately. See GLP-1s and NAION, GLP-1s and diabetic retinopathy and blurred vision on GLP-1s.

Bottom line

The 2025 Ontario study that linked GLP-1s to wet macular degeneration has not been confirmed by larger studies, including one of 5.6 million patients with diabetes that found no increased risk. If anything, several studies point to less dry AMD in GLP-1 users. But all of this is observational and rated very low certainty, so the honest answer is that a small risk can't be fully ruled out, and a protective effect can't be claimed either. Routine eye care matters more than the choice of medicine here.