A recent study published in JAMA Ophthalmology has uncovered a potential connection between the diabetes and weight loss medication semaglutide and a rare eye condition known as nonarteritic anterior ischemic optic neuropathy (NAION) which can result in blindness. This finding suggests that individuals with diabetes who were prescribed semaglutide were more than four times more likely to develop NAION compared to those taking other medications. Similarly, individuals who were prescribed semaglutide for weight loss were over seven times more likely to receive a NAION diagnosis compared to those taking other weight loss drugs.
NAION is a relatively rare but significant cause of blindness in the U.S., affecting around 2.3 people per 100,000. These individuals may experience a painless and permanent loss of vision, with most vision loss occurring rapidly within days or weeks of the onset of symptoms. While there is no established treatment protocol for NAION, experimental treatments are currently being evaluated globally. Normally afflicting middle-aged or older white individuals, NAION typically affects one eye first and may affect the other eye within three years for around 43% of people.
The lead author of the study, Joseph Rizzo, and colleagues from Mass Eye and Ear in Boston, Massachusetts, first began investigating the link between semaglutide and NAION after noticing an increase in NAION cases in patients taking the medication. Their analysis of retrospective data from over 16,000 patients revealed that those taking semaglutide for diabetes or obesity were significantly more likely to develop NAION compared to those taking other medications. While the exact mechanisms linking semaglutide to NAION are not completely understood, theories suggest that the drug may influence vascular health and blood flow, thereby increasing the risk of ischemic events in predisposed individuals.
To reduce the risk of developing NAION, it is essential to manage underlying health conditions such as controlling blood pressure and diabetes, scheduling regular eye examinations, and adopting a healthy lifestyle that includes balanced nutrition, regular exercise, and not smoking. Despite the study’s limitations, which include a small number of cases due to the rarity of NAION and data collection limitations, researchers emphasize the need for further research to confirm the link between semaglutide and NAION. They recommend that patients with optic nerve issues or significant visual loss discuss the potential risks with their healthcare providers when considering medications like semaglutide.
