Ozempic May Be Linked to Cause of Sudden Blindness, Another Study Shows

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 Recent research has shown a possible relationship between semaglutide—the main component in the weight reduction medications Ozempic and Wegovy—and a kind of abrupt visual loss known as non-arteritic anterior ischemic optic neuropathy (NAION). 1

This is the second research to imply a connection between semaglutide and the disease; the first was published in a peer-reviewed publication; the second has not. The disorder is characterized by a tiny vascular "stroke" of the optic nerve, which typically results in lifelong blindness. Annually, over 6,000 new cases are reported.2

While this new study does raise some concerns, experts agree that semaglutide and other glucagon-like peptide-1 (GLP-1) agonists, such as the diabetic and weight loss medicines Zepbound and Mounjaro, shouldn't put individuals off taking these treatments.

“Although there are some interesting studies on the topic, it is premature to conclude that the association between semaglutide and NAION is a causal association,” said Andrew Lee, MD, a neuro-ophthalmologist at Houston Methodist Hospital and spokesperson for the American Academy of Ophthalmology, in an interview with Health. While this study raises important questions, Lee stressed that further research is required to draw firm conclusions on the link between semaglutide and NAION. He also pointed out that the advantages of these drugs in treating diabetes and boosting weight reduction should not be underestimated, as they have been demonstrated to be successful for many patients. Ultimately, consumers contemplating these drugs should discuss any possible hazards with their healthcare professional and evaluate them against the benefits before making a choice.

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Motivation for the Study

The researchers aimed to explore the link between semaglutide and NAION because the previous work revealed a connection between the two. Anton PottegÃ¥rd, MSc, PhD, DMSc, a researcher at Odense University Hospital in Denmark and one of the authors of the new study, told Health. “This was initiated based on [an earlier study] from the U.S.,” PottegÃ¥rd added.

That research, published in July, drew on data from roughly 17,000 patients, 710 of whom had type 2 diabetes and 979 of whom were overweight or obese.

The research authors separated individuals in each category into two subcategories—those who had gotten a semaglutide prescription and those who hadn’t—and found that the semaglutide cohorts in both the type 2 diabetes and overweight/obesity groups exhibited greater rates of NAION.3

“That study is seemingly well conducted,” PottegÃ¥rd said, “but it is using a dataset that is quite peculiar, in that they only have data from patients that at some point had a contact with a specialist ophthalmologist [or neuro-ophthalmologist], which renders it quite difficult to draw conclusions from.”

Another study weakness was that the researchers didn’t know if all people administered semaglutide took the medications as planned, PottegÃ¥rd added. One possible reason for the greater incidence of NAION in the semaglutide groups might be owing to the fact that individuals with more severe diabetes or obesity may have been more likely to consult a specialized ophthalmologist. Without knowing whether all patients followed their recommended medication regimen, it is impossible to conclude if semaglutide itself is directly responsible for the increased incidence of NAION. Further study with a more diversified dataset and stringent adherence monitoring may give greater insights into the possible dangers connected with semaglutide usage.

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Exploring the Link Between Semaglutide and NAION

For the current research, Pottegård and his colleagues evaluated data from 44,517 patients in Denmark and 16,860 people in Norway, all of whom were eligible for semaglutide for the treatment of type 2 diabetes. Among the semaglutide users in Denmark, 24 persons got NAION; in Norway, there were eight instances.

Researchers observed that of 10,000 semaglutide users, one extra person may acquire NAION over the course of a year than would ordinarily be identified with the condition. Participants consequently had a greater risk of NAION while taking semaglutide, the researchers found, although “the absolute risk remains low.”1

“I think this is a worthwhile study to pay attention to when it is peer-reviewed and published,” Beverly Tchang, MD, an endocrinologist and associate professor of clinical medicine at Weill Cornell Medicine and an obesity medicine adviser at Ro, told Health. “The investigators performed several analyses to address potential confounders and selection bias and came to a similar conclusion as [the previous study], that NAION may be linked to semaglutide or GLP-1s.” 

That so, Tchang acknowledged, “The overall risk of NAION, regardless of GLP-1 use, seems to be very low.” 

“A person would have a very, very low chance of being that one in 10,000 person,” she added.

Experts underlined that we have no basis to think semaglutide causes NAION. “There is a biologically plausible mechanism for GLP-1 to cause worsening diabetic eye problems from tighter blood sugar control analogous to the worsening of diabetic retinopathy in similar patients,” Lee added. “The issue, however, is that association is not causation—and diabetes mellitus is a known risk factor for NAION.”

Right now, NAION is not mentioned as a recognized adverse effect of semaglutide, PottegÃ¥rd said. “These are among the first studies to investigate this phenomenon,” he stated. “Now, regulators will evaluate the findings to see whether it should be listed. From my understanding of the literature, including both our research and other studies on this, I feel it quite probable that it will be identified as a side effect.” 

Given that the study is still in its infancy, it’s unknown how compounded semaglutide—that is, medications with components blended together to match a person's particular needs—may increase NAION risk, experts noted.

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What This Means for People Considering Ozempic or Wegovy

Research tying NAION to semaglutide usage shouldn’t prevent individuals from taking the medicine if their doctor advises it, doctors said.

People who have a history of NAION may wish to discuss with their healthcare professionals the hazards of semaglutide.

“For the vast majority of users, there is no reason to consider this rare side effect,” PottegÃ¥rd added. “However, for patients with a history of NAION or patients experiencing NAION during treatment, they should know this is likely associated with their use of semaglutide and stop using the drug.” It is vital for people to assess the possible dangers and advantages of taking Ozempic or Wegovy, particularly if they have a history of NAION. Consulting with a healthcare expert may give useful insight and assistance on the best course of action. While the possibility of developing NAION while taking semaglutide is small, it is vital for people who are already at risk to be informed and take appropriate measures. Ultimately, making an educated choice with the support of a medical practitioner is crucial in assuring the safety and well-being of persons contemplating these drugs.

As research on the association between NAION and semaglutide usage continues, scientists may learn more about people most at risk. “Hopefully, in the future, we will better understand this and be able to point to specific patient subgroups at risk,” PottegÃ¥rd added.

Until then, persons who qualify for semaglutide should assess the advantages and dangers of taking the medicine.

“More research is necessary to test the hypothesis,” Lee stated. Until we have that, “patients should be aware of this information and, in consultation with their care team, make a careful, informed choice based on their individual risk profile.” It is vital for people to assess the possible advantages of semaglutide against the risks of developing NAION, particularly if they fall into specific high-risk groups. By being aware of the possible relationship between NAION and semaglutide usage, people may have more meaningful talks with their healthcare providers regarding the best course of action for their unique case. As research continues to study this relationship, it is vital for individuals to be knowledgeable and active in their healthcare choices.

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