Wegovy tied to higher risk of sudden vision loss than Ozempic, analysis suggests
Wegovy, the blockbuster weight-loss drug that contains semaglutide, may carry the highest risk of sudden vision loss among semaglutide medicines, according to a new analysis of U.S. safety reports published in the British Journal of Ophthalmology. The study linked the injections to ischaemic optic neuropathy — often called an “eye stroke” — and found the odds of the condition were roughly three times higher in men than in women.
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Semaglutide is sold by Novo Nordisk under several brands and formulations: Wegovy for chronic weight management, and Ozempic and Rybelsus for type 2 diabetes. All share the same active ingredient but differ by dosage and delivery; Ozempic is a lower-dose injection and Rybelsus is a daily pill.
Researchers examined reports submitted to the U.S. Food and Drug Administration’s Adverse Event Reporting System between December 2017 and December 2024. Out of more than 30 million total alerts in the database, 31,774 involved semaglutide products. Of those, 3,070 referenced Wegovy, which launched in 2021, and 20,608 referenced Ozempic, which received FDA approval in 2017.
Despite having fewer total reports, Wegovy showed the strongest association with ischaemic optic neuropathy (ION), a sudden loss of vision caused by reduced blood flow to the optic nerve. “Overall, ION risk appears dose and formulation dependent, and highest with Wegovy,” the authors wrote. “Ozempic’s earlier approval resulted in more reports than Wegovy, yet Wegovy showed the stronger signal.”
Further analysis suggested the odds of ION were nearly five times higher with Wegovy than with Ozempic. Men appeared more vulnerable overall, with more than triple the odds of ION compared with women, the study reported. The authors said the findings “highlight a potential dose-dependent safety concern that warrants urgent prospective evaluation to guide prescribing and regulatory policy.”
No cases of ION were reported in association with Rybelsus, the oral semaglutide. The study said that difference may reflect the “limited absorption and slower uptake” of the pill compared with injectable forms.
Ischaemic optic neuropathy is a rare but serious condition that typically presents as sudden, painless vision loss in one eye. The new analysis does not prove cause and effect but adds to ongoing safety scrutiny around popular GLP-1 medications as their use expands beyond diabetes into obesity treatment.
Novo Nordisk said patient safety is its top priority and that it takes reports of adverse events seriously, adding it works with regulators globally to continuously monitor the safety of its products. The company noted that European Union patient leaflets for Wegovy, Ozempic and Rybelsus have been updated to include non-arteritic anterior ischemic optic neuropathy (NAION), a form of ION. However, the company said its review of data “did not suggest a reasonable possibility of a causal relationship between semaglutide and NAION” and that it believes “the benefit-risk profile of semaglutide remains favourable.”
The authors called for rapid, prospective research to clarify whether dose or formulation meaningfully alters the risk of vision-related complications and to inform clinical guidance as demand for semaglutide drugs continues to grow.
By Abdiwahab Ahmed
Axadle Times international–Monitoring.
