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Hello George, I would like to write a private email to you. Please send me your email address. Thank you, Marc Gold marcgold@...

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HULLO ALL FEAR OF NAION AFFECTING OUR HEALTHY EYE LIVES WITH ALL OF US WE LOOK AT THE STATS FOR REASSURANCE IT WOULD BE SO HELPFUL, I’M SURE TO ALL TO HAVE A QUICK SURVEY IN OUR GROUP PKEASE DO ANSWER SO THAT WE CAN APPRECIATE THE REAL PICTURE I’LL START SEX MALE FIRST INCIDENT AGE 62 CURRENT AGE 66 SECOND INCIDENT AGE N/A COMPROMISED DISC CUP RATIO AFFECTED EYE YES UNAFFECTED EYE YES USING OZEMPIC OR SIMILAR NO HYPERTENSION YES POSSIBLE NOCTURNAL HYPOTENSION DIABETES NO SLEEP APNOEA NO CAUSAL RELATIONSHIP TO COVID ILLNESS MAYBE CAUSAL RELATIONSHIP TO COVID VACCINE MAYBE STILL DRIVING YES OTHER THIS WILL BE AN INVALUABLE SURVEY PLEASE DO ANSWER THANK YOU TERRY MEDICAL SPECIALIST

JUL 08, 2024 American Academy of Ophthalmology and North American Neuro-Ophthalmology Society Issue Advice on Weight Loss Drug and Eye Health SAN FRANCISCO — A new study suggests patients taking semaglutide — the active ingredient in Ozempic and Wegovy — may be at higher risk of developing an eye condition that can cause blindness. Non-arteritic anterior ischemic optic neuropathy or NAION, happens when blood flow to the optic nerve is blocked, causing sudden, painless loss of vision in one eye. Here’s what the American Academy of Ophthalmology and the North American Neuro-Ophthalmology Society want you to know about this study published July 3 in JAMA Ophthalmology: This is not the type of study that can show the treatment caused NAION. But the careful analysis conducted by the Harvard neuro-ophthalmology research team did identify a potential link between semaglutide treatment and NAION. This intriguing finding should inspire more research that will help clarify if semaglutide does cause NAION. Semaglutide was rigorously studied in several randomized, controlled trials worldwide. The U.S. FDA approved semaglutide for medical use in 2017. Many millions of people take this medicine throughout the world. This is the first study to report an association between semaglutide and NAION. The subjects in this study were either overweight or obese or had type 2 diabetes. People who have diabetes are already at risk of NAION. Other risk factors for NAION include heart disease, history of heart attack, high blood pressure, and sleep apnea. All the patients included in the study were seen at the same large eye hospital, which treats most of the region’s NAION patients, making it hard to determine if this association is true of all people taking semaglutide. A postmarketing surveillance study – a type of study that monitors the safety and effectiveness of a product after it has been released to patients – could be helpful in determining if there is a connection between semaglutide and NAION.Implications for Patients At this time, we do not recommend that people stop taking semaglutide. If you take semaglutide and have a sudden loss of vision, stop taking the drug and see a doctor immediately. Is it safe for people who previously had NAION? The study offers no information about people who previously had NAION who then developed it again following a prescription for semaglutide. Should people also be concerned about other diabetes drugs, such as tirzepatide (Zepbound or Mounjaro)? Semaglutide is the only drug investigated in this study. Patients should talk with their primary care physician to determine if semaglutide is right for them. NAION Symptoms The people in the study developed NAION symptoms following their first prescription of semaglutide. NAION symptoms include: Blurred vision Color distortion Loss of peripheral vision A dark or gray spot in the vision that doesn't move Loss of contrast or light sensitivity NAION usually happens without any warning. Vision loss can range from mild to severe. Most people don’t feel pain, but it can occur in up to 10 percent of patients. If there is pain, it may be an indication of another cause of vision loss. There is no cure for NAION.Other Vision Changes Linked to Semaglutide While the link to NAION is new, the medical community has been aware of other vision changes with semaglutide for some time. Previous studies have shown that semaglutide can cause blurred vision, worsening of diabetic retinopathy and macular complications. However, this appears to be a temporary side effect that goes away after three or four months. How can semaglutide cause temporary vision changes? When the body experiences a change in sugar level, it can affect the shape of the eye’s lens. This change is what causes blurry vision. Could a similar phenomenon be at play in this study? Could the ability of semaglutide to rapidly reduce glucose levels and blood pressure cause NAION and not the drug itself? It’s unknown. Only further research can answer that question. About the American Academy of Ophthalmology The Amer

Helpful recommendation .. get any device that monitors BP. If, for whatever reason, BP rises .. IMMEDIATELY REPORT TO ED/ER .. For myself, I dug deep, and got a Apple Watch with cellular. Also has "crash protection" -- in case of call, it calls 9-1-1 with GPS location. On Sunday, March 16, 2025 at 11:29:23 PM EDT, George Ousler via groups.io <sailfishin@...> wrote: Hi Marc, Thanks for your post. I feel obligated to let you know that I was in your shoes not too long ago (March 2024) and unfortunately suffered from a second NAION in my neighboring eye after using a GLP (Mounjorno) for approximately 6 months. I completely understand the risk vs. benefit ratio and that the improvements from weight loss, etc. are tremendous but I have to say that the potential loss of vision in both eyes is devastating. Once you have a NAION in both eyes, there may be significant blind spots based on the areas between your two eyes that overlap and therefore have true total vision loss (when there is only one eye involved, the neighboring eye compensates to the point where you don't notice the vision loss). I'm not suggesting that you change your opinion / plan, rather, just be sure that you can't control your diabetes, etc. through diet, other medications, etc. to try to prevent an ischemic event from GLP induced decreased blood flow. Also, do you have crowded disc syndrome (small cup to disc ratio in both eyes)? As you know, once it occurs, you can't reverse it. I've been seeing a neuro-ophthalmologist at Mass Eye and Eye who has been researching and publishing on the association between NAION and GLPs. Please google Dr. Rizzo at Mass General Hospitals and NAION to learn more. Happy to discuss more Marc (and anyone else in this group) to share my experience - once you have a second NAION, the game changes significantly. Thanks. George On Sunday, March 16, 2025 at 10:57:23 PM EDT, Marc Gold via groups.io <marcgold@...> wrote: The evidence of a link between Semaglutide and NAION is indeed very weak. I already have NAION in one eye. The improvement of my diabetes, weight, heart and kidney status worries me far more than the small chance my other eye could be affected by Ozempic. I start Ozempic next week @ 1 mg. per week. My physician concurs that the benefits far outweigh the risks. I'll take my chances, which are not high at all: https://journalretinavitreous.biomedcentral.com/articles/10.1186/s40942-024-00620-x#:~:text=In%20the%20present%20study%2C%20we,visual%20loss%20in%20the%20affected Even though we have demonstrated a higher risk of NAION in persons with T2D exposed to once-weekly semaglutide, it is important to keep in mind that use of semaglutide comes with substantial advantages for patients as given by the improved glycemic control, reduction in risk of cardiovascular disease as well as the beneficial effects of weight loss [1]. As such, the observed incidence rate of NAION of 0·228 per 1000 person-years for persons with T2D exposed with once-weekly semaglutide may not discourage semaglutide treatment but needs to be acknowledged as a potential risk. This is truly a miracle drug in the same way that penicillin, statin drugs, Covid vaccines, insulin and Sildenafil have demonstrated. We are lucky to live in this age of pharmaceutical advances and wonders. I will report my progress which should allay some of your concerns about Semaglutide and NAION. Marc

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1) Anyone have suggestions for the best phones for the visually impaired? 2) Anyone have suggestions for the best internet browsers? 3) Anyone have experiences with: Pentoxifylline (Trental) Citicoline Niacinmide B-3 (high doses)urrently experiencing NAION in 2nd eye and appreciate your experience and suggestions. Thank you. Debra B Debrownstein@gmail,com

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I had my "attack" in early August of 2022-within a month my vision decreased to 20/800 and has remained so until now. During the first 6 weeks of this episode, the pain was so bad I could not put my head on the pillow-I thought I had a severe ethmoid sinus infection that caused inflammation near the optic nerve, but I could not get anyone to listen. Finally, an MRI in November did confirm that I did have some "congestion" in the ethmoid sinus region, but the doctors didn't think it was significant. In February 2024, I had an ocular shingles attack on the same side-the pain was unbearable despite starting anti-viral therapy within 3 days of the outbreak. To this day I have numbness in the bridge of my nose, right eyebrow, and right eyelid (my right eye had the NAION attack). I still must monitor my diet to avoid foods high in arginine and I take 3 grams of lysine a day to reduce the risk of another attack. I cannot tolerate further anti-viral therapy due to a sensitivity that leads to kidney inflammation. In my research on my condition, I have discovered that ocular shingles does not always present with a rash-my neuro-ophthalmologist report on my condition said he thought I had a small disk to cup ratio but still wasn't 100% sure I had NAION. Also, ocular shingles has a very high rate of reoccurrence within 5 years and taking the shingles vaccine increases that risk. Could this have been a shingles attack all along? Paul The two hardest tests on the spiritual road are the patience to wait for the right moment and the courage not to be disappointed with what we encounter----Paulo Coelho I would be true, for there are those who trust me: I would be pure, for there are those who care; I would be strong, for there is much to suffer; I would be brave, for there is much to dare-Howard Walter On 03/08/2025 8:29 AM EST Russ Poter via groups.io <russpoter@...> wrote: 1/ my case: during mega-heavy workload, arguing with feds (ultimately involving Mr. Obama's office), in 2015 .. NAION attack, LEFT eye, 30% vision loss. Can still drive, if carefully. 2/ after a search, found great N.O. at top medical school, USAF during Vietnam (treated P.O.W. cases), published authority. ON CATARACT SURGERY .. N.O. advised, as much as possible, wait until ABSOLUTE last minute. Much research about, said surgery, involved with additional NAION attacks. *** IN ANY EVENT .. IN ANY MEDICAL TREATMENT .. ADVISE THAT NAION IS PRESENT. KEEP REPEATING -- NAION IS PRESENT. MANY PROVIDERS HAVE A DIFFICULT TIME, LISTENING CAREFULLY. PUT IT WRITING, COPY TO THEIR LEGAL COUNSEL. ON RETINAL TREATMENT .. very small hole in RIGHT eye, just discovered. Now .. WAIT & SEE. Medical school clinic, very aware, of stakes involved. To conclude: standand order .. step by step, day by day. We're not going to live forever. On Wednesday, March 5, 2025 at 11:49:18 AM EST, James Chevalley via groups.io <jimchevalley@...> wrote: There is so little known about NAION. And the info we gave seems full of contradictions. Like no anesthesia, or no flying, scuba diving. Even some face lotions used for Rosecia suggest a problem . Novacaine at the dentist. The list seems endless. With so few patients there is no money ear marked for research. I wish there were more clear answers . I also think there should be a screening of the optic nerve during an eye exam that would give people a heads up if they were prone to this problem. I'm 72 and have been to the eye doctor every year for an eye exam since I was 10 years old. Even after a retina tear on both eyes and a vistrectomy I was NEVER told about NAION till it happened 9 days after I had the 2nd vistrectomy. ??? All the tests and MRIs after the fact they claim my BP dropped too far . ?? Very gut wrenching.. On Tue, Mar 4, 2025, 3:55 PM Pamela Chadick via groups.io <apchadick88@...> wrote: Exactly! The most difficult thing is not knowing, or being able to prevent. I’ve been hypervigilant about protecting my left eye over the years and have been told that the chances of it occurring in that eye were slim. At this point, I’m most interested in

1/ my case: during mega-heavy workload, arguing with feds (ultimately involving Mr. Obama's office), in 2015 .. NAION attack, LEFT eye, 30% vision loss. Can still drive, if carefully. 2/ after a search, found great N.O. at top medical school, USAF during Vietnam (treated P.O.W. cases), published authority. ON CATARACT SURGERY .. N.O. advised, as much as possible, wait until ABSOLUTE last minute. Much research about, said surgery, involved with additional NAION attacks. *** IN ANY EVENT .. IN ANY MEDICAL TREATMENT .. ADVISE THAT NAION IS PRESENT. KEEP REPEATING -- NAION IS PRESENT. MANY PROVIDERS HAVE A DIFFICULT TIME, LISTENING CAREFULLY. PUT IT WRITING, COPY TO THEIR LEGAL COUNSEL. ON RETINAL TREATMENT .. very small hole in RIGHT eye, just discovered. Now .. WAIT & SEE. Medical school clinic, very aware, of stakes involved. To conclude: standand order .. step by step, day by day. We're not going to live forever. On Wednesday, March 5, 2025 at 11:49:18 AM EST, James Chevalley via groups.io <jimchevalley@...> wrote: There is so little known about NAION. And the info we gave seems full of contradictions. Like no anesthesia, or no flying, scuba diving. Even some face lotions used for Rosecia suggest a problem . Novacaine at the dentist. The list seems endless. With so few patients there is no money ear marked for research. I wish there were more clear answers . I also think there should be a screening of the optic nerve during an eye exam that would give people a heads up if they were prone to this problem. I'm 72 and have been to the eye doctor every year for an eye exam since I was 10 years old. Even after a retina tear on both eyes and a vistrectomy I was NEVER told about NAION till it happened 9 days after I had the 2nd vistrectomy. ??? All the tests and MRIs after the fact they claim my BP dropped too far . ?? Very gut wrenching.. On Tue, Mar 4, 2025, 3:55 PM Pamela Chadick via groups.io <apchadick88@...> wrote: Exactly! The most difficult thing is not knowing, or being able to prevent. I’ve been hypervigilant about protecting my left eye over the years and have been told that the chances of it occurring in that eye were slim. At this point, I’m most interested in finding out what people are doing to better the situation. Glasses, tools, computer screens for easier reading, etc. I’ve been very fortunate for 20 year in that my left eye was so strong. Although, I’m not sure where everything will settle, I can see pretty well straight ahead with my left eye, Lost the lower 1/3 and peripheral. On Mar 4, 2025, at 2:06 PM, Diane Keasler via groups.io <dlkeasler@...> wrote: ? Pamela, so sorry to learn your left eye now, after 20 years!, has had a NAION attack. I'm wondering, though you don't have any of the typical risk factors other than the biggie, small cup to disc ratio, if prior to this recent event, you had something that significantly either raised your BP such as significant pain or something that could have caused a drop in blood pressure such as dehydration? It is so hard not knowing what can be a trigger. Diane Keasler Hello. I am no longer using this email. Please update your contacts and use DLKeasler@... DLKeasler@... 505 Chatham Drive Chapel Hill, NC 27516 919-968-0099 THANK YOU!!! Life is the school, love is the lesson. On Tuesday, March 4, 2025 at 02:24:18 PM EST, Pamela Chadick via groups.io <apchadick88@...> wrote: Hello, I also have NAION in both eyes. The first time when I was 41in my right eye and most recently 3 weeks ago in my left eye. I'm now 61. I also have small cup to disc ration in both eyes. No diabetes, no blood pressure problems, really none of the risk factors that others sometimes have. I saw a dr. in Mobile, Al who specializes in optic nerve issues and she did something interesting that she said she's had good success with . She prescribed a solu medrol that I mixed with water and drank every morning for a few days and then I've been taken 50 mg of prednisone for the past 11 days. I'll start tapering off tomorrow. My doctor 20 years ago, who has passed, prescribed the IV steroids right away

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Vision loss: GLP-1 drugs like Ozempic linked to 3 eye conditions Vision loss: GLP-1 drugs like Ozempic linked to 3 eye conditions A new review reports that nine people taking semaglutide and tirzepatide — the active ingredient in GLP-1 medica... Diane Keasler Life is the school, love is the lesson.