The British journal of ophthalmologyMar 10, 2026

Risk of optic nerve damage linked to semaglutide varies by sex and drug form

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 16, 2026

Abstract

Among 31,774 cases, Wegovy is associated with a 74.89 reporting odds ratio for ischaemic optic neuropathy compared to Ozempic at 18.81.

Ischaemic optic neuropathy (ION) is linked to GLP-1 receptor agonists, especially semaglutide.
Men show a higher risk for ION, with a reporting odds ratio of 116.37.
Multivariable regression indicates that Wegovy poses a greater risk for ION than Ozempic, with an adjusted odds ratio of 4.74.
The findings suggest a potential dose-dependent safety concern that needs further investigation.

Simplified

Ischaemic optic neuropathy (ION) is a rare but vision-threatening complication recently linked to GLP-1 receptor agonists, particularly semaglutide. Using over 30 million reports from the FDA Adverse Event Reporting System (2017-2024), we evaluated formulation- and sex-specific associations. Among 31 774 semaglutide cases, Wegovy demonstrated the strongest signal for ION (reporting odds ratio (ROR)=74.89) compared with Ozempic (ROR=18.81). Sex-stratified analyses showed higher odds in men (ROR=116.37), and multivariable regression confirmed greater risk with Wegovy versus Ozempic (adjusted OR (AOR)=4.74) and in men versus women (AOR=3.33). These findings highlight a potential dose-dependent safety concern that warrants urgent prospective evaluation to guide prescribing and regulatory policy.

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Competing interests

Competing interests: Conflict of Interest: MP has received financial support (to the institution) from PSI Foundation and Fighting Blindness Canada. All other authors declare no financial or personal relationships with any organisations that could inappropriately influence (bias) the submitted work. This includes employment, consultancies, stock ownership, honoraria, paid expert testimony, patents, grants or travel funding within the past 3 years. No other relationships or activities have been identified as potential conflicts of interest for this manuscript.

PubMed

Risk of optic nerve damage linked to semaglutide varies by sex and drug form

Abstract

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Competing interests

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