A new study suggests that people taking semaglutide (Ozempic, Wegovy) may have a slightly increased risk of developing a rare but potentially blinding eye condition called nonarteritic anterior ischemic optic neuropathy (NAION).
The findings, published in JAMA Ophthalmology, indicate a 32% increased relative risk of NAION among semaglutide users compared to those not on the drug.
What is NAION?
NAION is a condition that causes sudden vision loss in one eye due to reduced blood flow to the optic nerve. The damaged optic nerve cells then struggle to transmit images to the brain, leading to permanent vision impairment.
What the Study Found
Researchers analyzed health records of more than 37 million people with type 2 diabetes, including over 810,000 individuals taking semaglutide. They found:
- The incidence rate of NAION among semaglutide users was just over 14 cases per 100,000 person-years.
- While there was a 32% increased risk compared to non-users, the study did not find a significantly higher risk when comparing semaglutide to other GLP-1 diabetes medications.
Conflicting Research and the Need for Further Study
This study follows a 2024 report from Mass Eye and Ear in Boston, which suggested an even higher—more than fourfold—increased risk of NAION with semaglutide. While the new research confirms a link, it indicates a lower risk than previously thought.
Despite these findings, the researchers emphasize that more research is needed to understand why semaglutide might increase the risk of NAION and to determine whether this risk is specific to the drug or part of a broader pattern seen with GLP-1 medications.
Should Patients Stop Taking Semaglutide?
While the findings raise concerns, experts caution against stopping semaglutide solely due to this risk. The drug provides significant benefits for people with type 2 diabetes and obesity, including:
- Better blood sugar control
- Significant weight loss
- Reduced risk of heart disease
- Lower chances of severe cardiovascular events
Dr. Joseph Rizzo, director of neuro-ophthalmology at Mass Eye and Ear, noted in an accompanying editorial that, given semaglutide’s many health benefits, the absolute risk of NAION appears to be low. He advised patients and doctors to balance the potential eye risk with the drug’s life-improving effects.
However, he recommended added caution for patients with existing vision problems or those who have already experienced vision loss from any cause before starting semaglutide.
Takeaway
While this study adds to concerns about semaglutide’s potential eye-related risks, the overall likelihood of developing NAION remains low. Patients should consult their doctors to weigh the benefits and risks before making any changes to their treatment.
Further research is needed to better understand this link and how best to monitor eye health in semaglutide users.
The research findings can be found in JAMA Ophthalmology.
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