Ozempic and rare vision loss: Study finds Increased risk in diabetes patients

In recent months, health officials and researchers have been examining the potential connection between Ozempic, a widely used medication for managing type 2 diabetes and obesity, and a rare but serious eye condition known as non-arteritic anterior ischemic optic neuropathy (NAION).

This investigation has been sparked by multiple studies that suggest a possible association between semaglutide, the active ingredient in Ozempic, and the onset of NAION, a condition that leads to sudden vision loss. While the risk remains relatively low, experts are urging both medical professionals and patients to be aware of the potential dangers.

Understanding NAION and its risks

NAION occurs when blood flow to the optic nerve is reduced, leading to irreversible vision loss. It is a leading cause of sudden blindness in older adults, though it’s rare, affecting about 10 in 100,000 people annually in the U.S.

The exact cause of NAION is unclear, but risk factors include age, high blood pressure, sleep apnea, and diabetes. Recent studies suggest that medications like Ozempic, used for diabetes and obesity, could contribute to this condition.

Researchers from institutions like Harvard and Mass Eye and Ear have found that semaglutide (a GLP-1 receptor agonist) might increase the risk of NAION compared to other diabetes medications over a three-year period.

The investigations into Ozempic’s potential role

The concern over semaglutide’s potential link to NAION has led to investigations by health authorities in Europe and the U.S. The Danish Medicines Agency (DMA) has been monitoring adverse event reports related to the condition.

The DMA asked the European Union’s Pharmacovigilance Risk Assessment Committee (PRAC) to assess the connection between GLP-1 medications like Ozempic and NAION. This request followed studies in Denmark and Norway suggesting semaglutide may contribute to a higher incidence of NAION.

A University of Southern Denmark study found that patients on semaglutide for diabetes had a two- to threefold increased risk of NAION compared to those on other drugs. However, these studies suggest a potential link, not a definitive cause.

Most studies of this nature are observational and cannot establish a clear cause-and-effect relationship. The results from these studies suggest that NAION could be a rare side effect of semaglutide, but more research is needed before any definitive conclusions can be drawn.

The findings from recent studies

U.S. studies found a sevenfold increased risk of NAION in patients taking semaglutide, but larger Danish studies showed a more modest risk, estimating 1.5 to 2.5 extra cases per 10,000 users annually. Despite its rarity, NAION can cause permanent vision loss.

A study in Denmark found a higher risk of NAION in patients using semaglutide compared to other medications like metformin, supporting concerns that semaglutide could contribute to the condition, though the evidence remains inconclusive.

As early as December 2024, the Danish Medicines Agency received 19 reports linking semaglutide to NAION. These reports are being investigated, but no clear pattern has been established yet. The DMA continues to review the data.

A small risk but significant consequences

Despite the growing body of evidence suggesting a link between semaglutide and NAION, experts caution that the risk remains very small for most patients. NAION is a rare disorder, and the vast majority of individuals using Ozempic or other GLP-1 medications do not experience any issues with their vision.

However, even a small increase in risk could have serious implications for patients, particularly those who are already at higher risk for vision problems due to underlying health conditions like diabetes or high blood pressure.

Given the well-established benefits of semaglutide in managing both diabetes and obesity, the risk of NAION must be carefully weighed against the substantial therapeutic benefits of the drug. Semaglutide has been shown to help regulate blood sugar levels and promote weight loss, which can have a positive impact on overall health and reduce the risk of complications from diabetes, including vision loss. For many patients, the benefits of using Ozempic will likely outweigh the potential risk of developing NAION.

However, health experts emphasize the importance of vigilance. If patients taking Ozempic as well as other GLP-1 medications experience sudden changes in their vision, they should seek medical attention immediately. Early intervention can sometimes help prevent further vision loss, especially in cases of NAION.

Eye care and staying active with aging

Maintaining good eye care and addressing any vision changes becomes even more crucial as we get older. Regular eye check-ups with an optometrist or ophthalmologist can help catch conditions like NAION before they lead to permanent vision loss. For older adults, staying active with aging is essential not only for maintaining physical health but also for preserving cognitive and visual functions.

Studies have shown that staying active can reduce the risk of developing eye conditions, such as macular degeneration and glaucoma, and can even help in the management of diabetes, which is a contributing factor to many eye diseases.

In addition to staying physically active, older adults may also benefit from using assistive devices to support their vision. Magnifying glasses, large-print books, and screen readers are just a few examples of tools that can make daily life easier for those experiencing vision challenges. Assistive devices help individuals maintain independence and stay engaged with daily activities, thereby improving overall quality of life.

Regulatory and manufacturer responses

Novo Nordisk, the maker of Ozempic, has addressed concerns over a potential link between the drug and NAION. The company stated that it has found no evidence connecting semaglutide to NAION and that the drug’s benefit-risk profile remains favorable.

The company also clarified that NAION is not listed as a side effect for Ozempic or Wegovy. Novo Nordisk continues to monitor reports and works with regulatory agencies to address any potential risks.

The Danish Medicines Agency, on the other hand, is proceeding cautiously. While it has not yet determined whether there is a direct link between semaglutide and NAION, it has requested further evaluation from the European Pharmacovigilance Risk Assessment Committee (PRAC). This ongoing review aims to provide a clearer understanding of whether the medication is contributing to the development of this serious eye condition.

Monitoring and moving forward

As studies progress, health authorities, including the FDA, will continue monitoring the safety of Ozempic and similar GLP-1 medications. Researchers are calling for more clinical trials and studies to better assess risks and identify factors that could increase the likelihood of developing NAION.

For now, healthcare providers are ensuring patients using Ozempic are informed of potential side effects and are closely monitored for vision issues. Those at higher risk, such as individuals with existing eye conditions, may be recommended alternative treatments.

Although the link between Ozempic and NAION remains under investigation, any potential risk, however small, should be taken seriously. Ongoing research will provide clarity, helping patients and healthcare providers make informed decisions.

A complex risk to consider

The investigation into the potential link between Ozempic and NAION underscores the complexities of medical treatments and the importance of ongoing research. While the evidence pointing to a connection between semaglutide and NAION is not yet definitive, the growing body of data warrants further scrutiny.

For now, patients using Ozempic should remain alert to any changes in their vision and seek medical advice if needed. As research progresses, health officials and patients alike will have a clearer understanding of the risks involved in using this medication for diabetes and weight management.

As part of staying active with aging, individuals should also remain vigilant about their eye care and utilize assistive devices when necessary to manage any vision challenges that arise. Ultimately, balancing treatment options with proactive care for overall health, including vision, remains key to maintaining a high quality of life as we age.