Ozempic, Wegovy Linked To Potential Vision Loss

People taking the weight-loss drug semaglutide could be at a slightly increased risk for a potentially blinding eye condition that affects the optic nerve, a new study says.

Patients on semaglutide (Ozempic, Wegovy) had a 32% increased relative risk of developing nonarteritic anterior ischemic optic neuropathy (NAION) compared to people not taking the drug, researchers reported Feb. 20 in JAMA Ophthalmology.

NAION typically causes sudden vision loss in one eye, according to Brigham and Women’s Hospital.

It’s thought to occur due to a loss of blood flow to the optic nerve, damaging the neurons that transmit images to the brain.

Previous studies also have detected this risk.

A 2024 study based at Mass Eye and Ear in Boston reported a more than fourfold increased risk of NAION with semaglutide, researchers said in background notes. That study also appeared in JAMA Ophthalmology.

The new study provides “further evidence of an association between semaglutide and NAION but show a smaller risk than that previously reported,” concluded the research team led by Dr. Cindy Cai, an assistant professor of ophthalmology at Wilmer Eye Institute at Johns Hopkins.

However, the new study also found that patients prescribed semaglutide did not have a significantly increased risk for NAION compared with other GLP-1 diabetes medications.

More research is needed to confirm this link and to identify why semaglutide might have this potential effect on vision, the researchers added.

“In the absence of a known mechanism for this association, we urge clinicians to weigh the concern for an increased risk of a rare but potentially blinding eye condition with the many therapeutic benefits of semaglutide,” researchers also concluded.

For the new study, they analyzed health records for more than 37 million people with type 2 diabetes, of whom more than 810,000 had been prescribed semaglutide to help manage their diabetes.

The incidence rate of NAION among semaglutide users was just over 14 cases for every 100,000 person-years. Person-years refers to both the number of people in a study and the length of time researchers tracked their health.

“Semaglutide has a wealth of systemic benefits, but patients and prescribers of the medication should be aware of the association with an increased risk for NAION,” Cai told Healio, a website for health professionals.

In an accompanying editorial, researchers behind the 2024 study urged that the possible NAION risk from semaglutide be considered in the context of the drug’s many benefits.

“GLP-1RA drugs have provided considerable benefit to millions of users, including an increased chance of improved management of T2D [type 2 diabetes], substantial reduction in body weight, substantially improved morbidity and mortality of major adverse cardiovascular events, and even reduced addictive behaviors,” the editorial co-written by Dr. Joseph Rizzo, director of the neuro-ophthalmology service at Mass Eye and Ear, said.

“In our opinion, based on our current knowledge, patients should not stop taking semaglutide on this account alone, especially given potential increases in morbidity from conditions that are well controlled by semaglutide, potential adverse effects of hyperglycemia caused by abrupt cessation of treatment, and the seemingly low absolute risk of NAION,” the editorial said.

“However, it seems prudent to advise added caution for patients taking semaglutide or those who are considering starting this medication if they have experienced visual loss from any cause,” the editorial concluded.

More information

Brigham and Women’s Hospital has more on NAION.

SOURCE: JAMA Ophthalmology, Feb. 20, 2025

Source: HealthDay