GLP-1 drugs for weight loss Ozempic, Wegovy linked to vision loss: What is NAION, who is at risk and what symptoms should users watch for?

Popular GLP-1 weight loss drugs including Ozempic and Wegovy will carry a new warning about a possible rare side effect that can sometimes lead to permanent vision loss, US health regulators announced Monday. The condition, called non-arteritic anterior ischemic optic neuropathy (NAION), can lead to significant vision loss. According to the FDA, it has been reported in connection with all GLP-1 drugs and occurs when blood flow to the optic nerve is reduced. However, the exact cause behind this reduced blood flow remains unclear.

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“The FDA is informing patients and health care providers of a potential increased risk of non-arteritic anterior ischemic optic neuropathy (NAION) associated with use of glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications,” the US regulator's bulletin said. “NAION is a rare condition that can result in acute, painless, decreased vision in one eye, including permanent vision loss.”


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Side effects of GLP-1 weight loss drugs

The Food and Drug Administration on Monday said popular GLP-1 weight-loss medications such as Ozempic, Wegovy and others must put a warning about greater risks for permanent vision loss on their packaging. The federal agency’s requirement also extends to Mounjaro, Zepbound and Soliqua. The condition reduces blood flow to the optic nerve, causing sudden vision loss in one eye. There is no known treatment to reverse the vision loss. GLP-1 drugs are used to treat obesity and diabetes and has become popular for weight loss.

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Who is more vulnerable to vision loss?

People with certain underlying health conditions may have a higher risk of developing non-arteritic anterior ischemic optic neuropathy (NAION). These include:

- Diabetes: People with diabetes may have an increased risk of optic nerve damage and blood vessel problems.

- High blood pressure: Hypertension can affect blood circulation and is a recognised risk factor.

- Sleep apnoea: Obstructive sleep apnoea has been associated with a higher risk of NAION.

- High cholesterol: Vascular risk factors can contribute to problems affecting blood supply to the optic nerve.

- Older age: NAION is more commonly diagnosed in people over 50, although younger people are not entirely exempt.

What symptoms should users watch for?

NAION typically causes sudden, painless vision loss, often affecting one eye. Symptoms may include:

- Sudden blurring or dimming of vision in one eye.

- A dark or blurred area in the upper or lower part of the visual field.

- Reduced peripheral vision.

- Difficulty seeing clearly or noticing missing areas in the field of vision.

- Sudden changes in eyesight, particularly upon waking.

What FDA said on weight loss drugs

“Data from an analysis of 126 randomised, controlled clinical trials across multiple GLP-1 RAs showed an occurrence of 6.4 NAION cases per 100,000 person-years (PY) in patients treated with GLP-1 RAs compared to 3.8 NAION cases per 100,000 PY for patients treated with a placebo or a non-GLP-1 RA glucose-lowering medication,” the FDA explained.

According to ABC News, Novo Nordisk, the maker of Ozempic and Wegovy, said that “available research does not establish that GLP-1 medications cause NAION”.

Regardless, the FDA is insisting that the drug manufacturers “add information to the warnings and precautions section of labelling about the potential increased risk of NAION associated with use of these medications”.