Ozempic has become one of the best-known medicines for type 2 diabetes.
The drug, whose active ingredient is semaglutide, helps lower blood sugar and can also lead to significant weight loss. New research, however, has raised questions about a rare eye problem that can cause permanent loss of vision.
Researchers from the University of Southern Denmark and collaborators examined whether people using semaglutide were more likely to develop non-arteritic anterior ischemic optic neuropathy, usually shortened to NAION. This condition occurs when blood flow to part of the optic nerve is reduced. The optic nerve carries signals from the eye to the brain, so damage to it can suddenly affect sight.
NAION is uncommon, but it can be serious because lost vision is often permanent. A person may suddenly notice blurred, darkened, or missing areas of vision, usually in one eye. Diabetes itself, high blood pressure, older age, and other health problems can also increase the risk of the condition.
Interest in a possible connection with semaglutide grew after earlier research in the United States reported more cases of NAION among people prescribed the medicine. Scientists in Denmark and Norway then used large health databases to investigate the question in much bigger populations.
One analysis included more than 424,000 people with type 2 diabetes, including over 106,000 who received semaglutide. The researchers reported that people using the drug had roughly twice the risk of NAION compared with people receiving some other diabetes treatments. Because the condition is rare, however, doubling the relative risk still translates into a small number of additional cases.
The researchers also examined changes in Denmark over time. Before semaglutide became widely used, the country recorded roughly 60 to 70 NAION cases each year. More recently, the annual number was reported to be around 150, although this increase alone cannot prove that Ozempic caused the additional cases.
A separate analysis compared people who had recently started semaglutide with patients beginning other diabetes medicines. This type of comparison can help reduce some differences between long-term users of different treatments. Once again, the researchers found evidence of an increased NAION risk among people taking semaglutide.
The findings were reported in the International Journal of Retina and Vitreous, while related research was also made available as a preprint on medRxiv. A preprint is a research paper released publicly before completing the journal peer-review process. Together, the studies add to growing evidence of a possible association, but they do not mean that most Ozempic users are in danger of losing their sight.
For many people with type 2 diabetes, semaglutide has important benefits. Better blood sugar control can reduce complications of diabetes, while this class of medicines has also shown benefits for the heart and kidneys in appropriate patients. Doctors therefore have to consider the small possible eye risk alongside these established benefits.
People taking Ozempic should not stop the medicine because of these findings without speaking with their doctor. Suddenly changing diabetes treatment can cause blood sugar to rise and may create other health risks. Patients who have previously experienced NAION or have significant eye problems may want to discuss their individual situation with a healthcare professional.
Sudden vision loss or a major unexplained change in eyesight should receive urgent medical attention, whether or not someone uses Ozempic. Fast assessment can help doctors determine what is causing the problem and rule out other emergencies. Regular eye examinations are also important for people with diabetes because the disease itself can damage the eyes.
The new research does not erase the benefits of Ozempic, but it gives doctors another possible risk to consider when choosing treatment.
As semaglutide is now used by millions of people, even rare side effects deserve careful study. Continued monitoring should help researchers determine which patients, if any, face the greatest risk.
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