Clinical Report: Wegovy and Possible Vision Risk

Overview

An observational analysis of over 30 million FDA adverse event reports indicates that semaglutide, particularly in its Wegovy formulation, is associated with a significant risk of ischaemic optic neuropathy (ION). The findings suggest a nearly fivefold increased risk of ION with Wegovy compared to Ozempic, highlighting the need for caution among prescribing clinicians.

Background

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have become essential in managing type 2 diabetes and obesity. However, emerging evidence raises concerns about potential ocular risks associated with these therapies, particularly with semaglutide. Understanding these risks is critical for clinicians as GLP-1RAs continue to be widely prescribed.

Data Highlights

Key Findings

• Semaglutide is the only GLP-1RA associated with a significant signal for ION.
• Wegovy shows the strongest association with ION compared to Ozempic.
• ION risk is nearly five times higher with Wegovy than with Ozempic.
• Men receiving Wegovy have particularly high reporting odds for ION.
• No ION cases were reported with oral semaglutide (Rybelsus).
• No signal for ION was detected with tirzepatide or comparator drugs like metformin.

Clinical Implications

Clinicians should be aware of the potential increased risk of ION associated with semaglutide, especially in patients prescribed Wegovy. Monitoring for visual symptoms in patients receiving high-dose semaglutide may be warranted, and further research is needed to clarify the relationship between GLP-1RAs and ocular health.

Conclusion

The findings underscore the importance of vigilance in monitoring patients on semaglutide for potential ocular complications, particularly with the Wegovy formulation. Further studies are essential to establish a definitive link and identify at-risk populations.

References

1. American Diabetes Association, ADA, 2025 -- The American Diabetes Association Releases Standards of Care in Diabetes—2025
2. JAMA Network, JAMA Ophthalmology, 2023 -- Semaglutide and Nonarteritic Anterior Ischemic Optic Neuropathy
3. Eyecare Business — Low Vision
4. Retinal Physician — Vitreoretinal Views on Vuity
5. Ophthalmology Management — DISCUSSING IOL OPTIONS WITH PATIENTS
6. Glaucoma Physician — Cost-benefit Analysis of Virtual Reality Visual Fields as Adjunct to Standard Automated Perimetry Recommendations
7. Low Vision
8. Vitreoretinal Views on Vuity
9. Discussing IOL Options with Patients
10. The American Diabetes Association Releases Standards of Care in Diabetes—2025 | American Diabetes Association
11. Semaglutide Treatment Effect in People With Obesity - American College of Cardiology
12. Semaglutide and Nonarteritic Anterior Ischemic Optic Neuropathy | Diabetes | JAMA Ophthalmology | JAMA Network