Recently a study published in JAMA Ophthalmology from Harvard Medical School and Mass Eye and Ear, found evidence that the active ingredient (semaglutide) in the trendy GLP-1 weight loss drugs such as Wegovy and Ozempic can in rare cases cause blindness.
Trendy drug doubles the risk of NAION
Now two independent studies from the University of Southern Denmark support the findings of the ophthalmologists from Harvard, finding that the popular weight loss and diabetes medicine more than doubles the risk of a severely debilitating eye condition called non-arteritic anterior ischemic optic neuropathy (NAION).
NAION is damage to the optic nerve that is caused by a sudden stop of blood flow, it is an irreversible condition that can lead to sudden severe and permanent loss of vision, explains Jakob Grauslund, Professor of Ophthalmology at the Department of Clinical Research, SDU, and Department of Ophthalmology E, Odense University Hospital.
NAION often develops in those with an elevated risk of cardiovascular disease, and the risk factors are sleep apnea, age, diabetes, high cholesterol levels, and high blood pressure. While the exact causes are not fully understood, it is the second most common cause of optic nerve damage-induced blindness.
Ozempic doubles the risk
While the numbers were higher in the American study, all 3 of these studies found a link between GLP-1 medication and NAION. One of the Danish studies found a 2 to 3 times increased risk of those taking Semaglutide developing NAION, the American study found that Ozempic more than doubles the risk, and the other Danish study found that Ozempic doubles the risk, noting that hospitalized patients with NAION are more often those with type 2 diabetes.
The studies
Jakob Grauslund: Once-weekly semaglutide doubles the five-year risk of nonarteritic anterior ischemic optic neuropathy in a Danish cohort of 424,152 persons with type 2 diabetes, published in the International Journal of Retina and Vitreous. If a person with diabetes takes Ozempic they are more than twice as likely to develop NAION.
Anton Pottegård: Use of semaglutide and risk of non-arteritic anterior ischemic optic neuropathy: A Danish–Norwegian nationwide study undergoing peer-review at medrxiv comparing those who started new medication with those who started Ozempic who developed NAION, finding Ozempic carries a 2.81 times greater risk of developing NAION for those with type 2 diabetes.
Type 2 diabetes left untreated
It is worth noting that if left untreated diabetes can lead to changes and complications in the eyes. While they are less severe than NAION they are far more common, thus it is not the intent of the researchers to advise diabetes patients to stop taking their treatment. Rather a piece of the puzzle to understanding how these drugs work to be used as a discussion between doctors and patients regarding the pros and cons of these medications.
“It is extremely important that type 2 diabetes is treated, but you have to consider whether the small increased risk of severe vision loss by using Ozempic means that you should instead use one of the other new drugs that protect against kidney and cardiovascular disease. This is commensurate with the new guidelines which came into force on 25 November.”
“We cannot yet with certainty identify patients with a particularly high risk. However, treatment with Ozempic should be stopped if NAION is detected in one eye. The vast majority of patients can be confident in receiving treatment with Ozempic, as the absolute risk is so low, but some people may prefer an alternative treatment following consultation with their doctor,” said co-author Kurt Højlund is a professor of diabetes at Steno Diabetes Center Odense, SDU and Odense University Hospital.
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References/Sources/Materials provided by:
https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2820255
https://www.medrxiv.org/content/10.1101/2024.12.09.24318574v1
