Ozempic and Wegovy May Increase Risk of Vision Loss

A new study found that people taking semaglutide had a higher risk of developing a rare and potentially blinding condition called nonarteritic anterior ischemic optic neuropathy.

As the popularity of injectable weight loss and diabetes medications like semaglutide (Ozempic and Wegovy) have increased in the past few years, so has the list of potentially adverse side effects associated with this and other glucagon-like peptide-1 (GLP-1) receptor agonists.

For example, the drugs have been linked to suicidal thoughts, stomach paralysis, hair loss, and blocked intestines. In response to reports of potentially harmful side effects, the U.S. Food and Drug Administration (FDA) is evaluating these medications to determine if regulatory action is needed.

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Now, new research published July 3 in JAMA Ophthalmology has revealed another side effect of taking semaglutide, one that can potentially lead to blindness.

The study was initiated in late 2023 after neuro-ophthalmologists at Mass Eye and Ear, a department of Mass General Brigham Hospital, diagnosed three patients in one week with nonarteritic anterior ischemic optic neuropathy (NAION). All three of the patients were taking semaglutide.

NAION is a rare eye condition that impacts the optic nerve. Though uncommon, it's the second leading cause of optic nerve-related blindness, following glaucoma.

Health experts believe the condition is caused by a reduction of blood flow to the optic nerve head leading to painless vision loss. Moreover, blindness resulting from NAION is permanent, and there are currently no treatments for the condition.

To investigate whether semaglutide was associated with NAION, a team of researchers pulled data from nearly 17,000 people who were evaluated by doctors at Mass Eye and Ear from December 2017 to November 2023.

The team evaluated the incidence of NAION in people with type 2 diabetes or obesity who were taking semaglutide and those who took other diabetes or weight loss drugs.

After accounting for factors like sex, hypertension, obstructive sleep apnea, and coronary artery disease, the researchers found that people prescribed semaglutide had a higher risk of developing NAION.

Specifically, among those with type 2 diabetes, 17 cases of NAION occurred in people using semaglutide, while only six occurred in those not taking the drug. In patients with a high BMI or obesity, 20 NAION events occurred in individuals prescribed semaglutide versus three cases in the non-semaglutide group.
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Still, the team couldn't determine whether every patient actually took the medications as directed. However, they did confirm that all of the individuals diagnosed with NAION picked up their prescriptions.

Moreover, since it's a specialty institution, Mass Eye and Ear sees a relatively high number of patients with rare eye conditions, and the number of NAION cases during the study period was relatively small.

In a news release, Joseph Rizzo, M.D., director of the Neuro-Ophthalmology Service at Mass Eye and Ear, said, "Our findings should be viewed as being significant but tentative, as future studies are needed to examine these questions in a much larger and more diverse population."

Despite the need for more research, the study's authors say this new information should be included in discussions between patients and their doctors, especially if patients have preexisting optic nerve problems like glaucoma or visual loss from other causes.

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