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People taking Ozempic and Wegovy may be at increased risk of developing a debilitating eye condition that can cause irreversible vision loss, a study published Wednesday in JAMA Ophthalmologyfinds. The authors stressed, however, that more studies are needed to confirm a link between the blockbuster drugs and vision problems.
Non-arteritic anterior ischemic optic neuropathy, or NAION, is a condition that affects the optic nerve, a bundle of fibers that connects to the back of the eye and carries signals to the brain so a person can see. In people with NAION, blood flow to the optic nerve gets reduced or blocked, leading to sudden vision loss.
“It is, in effect, a stroke of the optic nerve,” said senior study author Dr. Joseph Rizzo, the director of neuro-ophthalmology at Mass Eye and Ear in Boston.
NAION is the second most common optic nerve disease in the U.S., occurring in up to 10 out of 100,000 people, according to the American Academy of Ophthalmology, and it’s one of the most common causes of sudden blindness. The condition is permanent with no known treatment.
The new study was based on an analysis of medical records spanning six years from more than 16,800 patients in the Boston area, none of whom were initially diagnosed with NAION.
The researchers focused on a subset of those patients — about 1,700 — who either had diabetes, were overweight or had obesity, and compared outcomes after 36 months in those who were prescribed semaglutide to those who weren’t. Semaglutide is the ingredient in Ozempic and Wegovy.
Almost 200 of the diabetes patients were prescribed semaglutide and 17 went on to develop NAION, a rate more than four times higher than those not prescribed the drug. For the obesity group, 361 people were prescribed semaglutide and 20 people developed the condition, a seven times higher rate.
Rizzo said that because the findings were based on a review of existing data, researchers can’t say for sure whether semaglutide causes the eye condition. He said a large, randomized controlled clinical trial is still needed to confirm a link.
“What it does show is an association between taking semaglutide and developing this condition where you lose vision,” he said.
Dr. Andrew Lee, clinical spokesperson for the American Academy of Ophthalmology and a neuro-ophthalmologist at Houston Methodist Hospital, said he's had some patients who developed NAION who were taking semaglutide, but the question was always whether “this is a causal association or merely an association alone.”
People with Type 2 diabetes are already at an increased risk for vision problems, including NAION. Another vision problem, diabetic retinopathy, is the leading cause of blindness in adults and is caused by damage to the retina from high blood sugar levels.
What’s more, risk factors for NAION include sleep apnea and hypertension, which are diseases that are more likely to occur in people with obesity.
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