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Individual case reports, pharmacovigilance signals, and post-marketing observations can raise concern about the worst vision side effects of Zepbound, but causality requires structured evaluation, including: Baseline incidence rates in relevant populations Confounder adjustment (diabetes, hypertension, sleep apnea, dyslipidemia) Temporal association and dechallenge patterns Mechanistic plausibility Consistency across datasets However, clinical prudence does not require perfect certainty before acting on a high severity signal

Isolated rat islets stimulated by GLP-1 have anti-diabetic effects through the activation of GLP-1 receptor agonists [29]

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