Key Takeaways

• A study of 227,971 adults with type 2 diabetes found no evidence that semaglutide increases or decreases the risk of wet AMD
• Researchers compared semaglutide users with patients taking other GLP-1 receptor agonists and several non-GLP-1 diabetes medications, finding no statistically significant differences in AMD risk

A large international study has found no evidence that semaglutide, the blockbuster diabetes and weight-loss medication, increases the risk of developing wet age-related macular degeneration (AMD).¹

The research, published in Ophthalmology, examined health records from more than 227,000 adults with type 2 diabetes who were prescribed semaglutide. Investigators found that patients taking the drug were no more likely to develop wet AMD than patients using several other commonly prescribed diabetes medications.

The findings address growing questions about the eye safety of semaglutide and other glucagon-like peptide-1 receptor agonists (GLP-1RAs), a class of drugs that has transformed the treatment of diabetes and obesity in recent years.

“Recent studies have reported conflicting results regarding the relationship between semaglutide and macular degeneration,” the researchers noted. Some earlier analyses suggested an elevated risk of wet AMD, while others reported a potential protective effect.

To clarify the issue, researchers from the Observational Health Data Sciences and Informatics (OHDSI) network conducted a large retrospective study using data from 12 healthcare databases spanning electronic health records and insurance claims. The study period covered December 2017 through December 2024. A total of 227,971 new users of semaglutide were included in the study.

The team compared semaglutide users with patients taking other GLP-1 medications, including dulaglutide and exenatide, as well as non-GLP-1 diabetes drugs such as empagliflozin, sitagliptin and glipizide. They also used a separate self-controlled analysis that compared patients’ risk during periods when they were taking the medication versus periods when they were not.

Across both approaches, the researchers found no statistically significant increase in the risk of wet AMD associated with semaglutide use.

The risk of NVAMD among semaglutide users was similar to users of dulaglutide (NVAMD-C HR 0.57, 95% CI 0.21 to 1.57, P=.28; NVAMD-CP HR 0.25, 95% CI 0.05 to 1.27, P=.10), empagliflozin (NVAMD-C HR 0.98, 95% CI 0.54 to 1.79, P=.94; NVAMD-CP HR 0.79, 95% CI 0.38 to 1.64, P=.52), sitagliptin (NVAMD-C HR 2.08, 95% CI 0.90 to 4.83, P=.09; NVAMD-CP HR 1.80, 95% CI 0.55 to 5.86, P=.33), and glipizide (NVAMD-C HR 0.83, 95% CI 0.35 to 2.02, P=0.69; NVAMD-CP HR 0.50, 95% CI 0.21 to 1.19, P=.12). There was no evidence of increased or decreased risk for NVAMD associated with semaglutide exposure (NVAMD-C: incidence rate ratio [IRR] 0.92, 95% CI 0.67 to 1.26, P=.60; NVAMD-CP IRR 1.02, 95% CI 0.76 to 1.36, P=.92) nor any of the other GLP-1RA or non-GLP-1RAs.

“Our findings suggest that semaglutide is not associated with a large increase or decrease in NVAMD risk among adults with type 2 diabetes,” the authors concluded.

The study also found no evidence that the comparison diabetes medications altered the risk of NVAMD.

The authors cautioned that their study cannot completely rule out small effects in either direction. Because the research relied on diagnostic and procedure codes in healthcare databases, some uncertainty remains regarding disease classification. In addition, the overall number of wet AMD cases was relatively small compared with the size of the study population. Still, researchers said the study’s scale, diverse patient populations and rigorous methodology strengthen confidence in the results. 

Reference

1. Cai CX, Toy B, Martin B, et al. Semaglutide and neovascular age-related macular degeneration among adults with type 2 diabetes: an OHDSI network study. Ophthalmology. Published online May 21, 2026. doi:10.1016/j.ophtha.2026.05.034.