In a joint statement, AAO and the North American Neuro-Ophthalmology Society (NANOS) shared their advice in response to a recently published study in JAMA Ophthalmology that suggests patients taking semaglutide — the active ingredient in Ozempic and Wegovy — may be at higher risk of developing non-arteritic anterior ischemic optic neuropathy (NAION), an eye condition that can cause blindness.

The AAO and NANOS offered the following comments for ophthalmologists on the study: 

• This is not the type of study that can show the treatment caused NAION. But, the careful analysis conducted by the Harvard neuro-ophthalmology research team did identify a potential link between semaglutide treatment and NAION. This intriguing finding should inspire more research that will help clarify if semaglutide does cause NAION.

• Semaglutide was rigorously studied in several randomized, controlled trials worldwide. The FDA approved semaglutide for medical use in 2017. Many millions of people take this medicine throughout the world. This is the first study to report an association between semaglutide and NAION.

• The subjects in this study were either overweight or obese or had type 2 diabetes. People who have diabetes are already at risk of NAION. Other risk factors for NAION include heart disease, history of heart attack, high blood pressure and sleep apnea.

• All the patients included in the study were seen at the same large eye hospital, which treats most of the region’s NAION patients, making it hard to determine if this association is true of all people taking semaglutide. A postmarketing surveillance study — a type of study that monitors the safety and effectiveness of a product after it has been released to patients — could be helpful in determining if there is a connection between semaglutide and NAION.

The AAO and NANOS said they do not recommend that people stop taking semaglutide at this time. However, they urge, if you take semaglutide and have a sudden loss of vision, stop taking the drug and see a doctor immediately. 

Addressing if semaglutide is safe for people who previously had NAION, the AAO and NANOS said the study offers no information about people who previously had NAION who then developed it again following a prescription for semaglutide. 

In addition, regarding NAION symptoms, the AAO and NANOS stated that the people in the study developed NAION symptoms following their first prescription of semaglutide. The symptoms included blurred vision, color distortion, loss of peripheral vision, a dark or gray spot in the vision that doesn't move, and loss of contrast or light sensitivity. 

Finally, in regard to other vision changes linked to semaglutide, the AAO and NANOS said that while the link to NAION is new, the medical community has been aware of other vision changes with semaglutide for some time. Previous studies have shown that semaglutide can cause blurred vision, worsening of diabetic retinopathy and macular complications. However, this appears to be a temporary side effect that goes away after 3 or 4 months.