What an Ophthalmologist Should Know about the Side Effects of “Ozempic” and its Analogues

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Abstract
Modern notions of beauty, dominant in the media and online, persistently promote the idea of “eternal youth”, including the need for a slim figure. Consequently, medications originally developed for the treatment of various systemic diseases are often used without medical indications and without physician supervision for the purpose of weight loss and/or rejuvenation. A striking example is the widespread use of human glucagon-like peptide-1 (HGLP-1) analogs (“Ozempic”, “Munjaro”, etc.), which were developed for the treatment of type 2 diabetes and associated obesity. This has led to the use of these drugs not only for the treatment of the aforementioned condition but also for weight loss in otherwise healthy individuals. An analysis of scientific literature and our clinical observations indicate a high risk of a wide range of side effects with this group of medications. The most common complaints include nausea, diarrhea, vomiting, and constipation, occurring in 39–42 % of patients. Additionally, cases of pancreatitis have been described, as well as an increased risk of gallstones, renal failure, anesthesia-related risks such as aspiration of gastric contents into the respiratory tract, and carcinogenic effects such as thyroid and pancreatic cancer. A significant number of studies have documented the development of ophthalmic pathology associated with the use of “Ozempic” and its analogs, including non-arteritic anterior ischemic optic neuropathy — an acute condition characterized by sudden, painless, and irreversible vision loss. Other studies have documented cases of macular edema and progression of diabetic retinopathy. The “Ozempic face” effect — a change in facial appearance (wrinkles, a sunken appearance) due to the rapid loss of subcutaneous fat — is mentioned in the literature. It prompts patients to seek dermal filler injections from cosmetologists, which, consequently, increases the risk of ophthalmological complications, particularly central retinal artery occlusion. It should be noted that decreased appetite associated with this class of drugs is largely due to their mechanism of action on the central nervous system and is accompanied by changes in taste preferences (a decrease in intense taste sensations), as well as increased depression, anxiety, and, in some cases, suicidal ideation. Although the effectiveness of therapy with human glucagon-like peptide-1 analogues has been proven, further research is needed to assess the risk of severe side effects associated with their use, as well as to inform physicians and patients about potential complications to ensure timely medical care, including in ophthalmology.

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