Newswise — Last month, the European Medicines Agency recommended that product information for semaglutide medicines — the active ingredient in Ozempic, Rybelsus, and Wegovy — be updated to include non-arteritic anterior ischemic optic neuropathy or NAION as a ‘very rare’ side effect. If a physician confirms a diagnosis of NAION, the Agency recommends treatment with semaglutide (glucagon-like peptide-1 (GLP-1) receptor agonists) be stopped immediately.
NAION happens when blood flow to the optic nerve is blocked, causing sudden, painless loss of vision in one eye.
The American Academy of Ophthalmology and the North American Neuro-Ophthalmology Society (NANOS) do not support such a blanket recommendation for all patients. We conclude that discontinuing semaglutide could pose significant health risks to patients’ overall health.
Instead, we recommend that patients who develop NAION while on semaglutide engage in a shared decision-making process with their physicians, including their ophthalmologist, neurologist, primary care physician, or endocrinologist. This discussion should consider the individual’s overall health, risk factors, and therapeutic options to make an informed decision about whether to continue or discontinue semaglutide.
It’s important to remember that for some patients — those with obesity or those whose diabetes has been difficult to manage with other therapies, and especially those with underlying vascular health conditions — discontinuing semaglutide may pose significant health risks to their overall health.
The actual risk posed to an individual’s eye health also needs to be kept in context. A review of the available data has not established that semaglutide causes NAION, only a potential link between the two. The overall risk for NAION remains low, even among those on semaglutide.
The European Medicines Agency’s review determined that NAION may affect up to 1 in 10,000 people taking semaglutide.
About the American Academy of Ophthalmology
The American Academy of Ophthalmology is the world’s largest association of eye physicians and surgeons. A global community of 32,000 medical doctors, we protect sight and empower lives by setting the standards for ophthalmic education and advocating for our patients and the public. We innovate and support research to advance our profession and to ensure the delivery of the highest-quality eye care. Our EyeSmart® program provides the public with the most trusted information about eye health. For more information, visit aao.org.
About the North American Neuro-Ophthalmology Society
The North American Neuro-Ophthalmology Society (NANOS) is a professional organization of about 700 members who are fully trained ophthalmologists or neurologists. NANOS is dedicated to achieving inclusive excellence in the care of patients with neuro-ophthalmic diseases by the support and promotion of equitable education, research, and the practice of Neuro-Ophthalmology. Visit our official website to learn more.
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