Semaglutide Ups Risk for Nonarteritic Anterior Ischemic Optic Neuropathy in Diabetes
TUESDAY, April 8, 2025 -- For patients with diabetes, semaglutide use is associated with an increased risk for nonarteritic anterior ischemic optic neuropathy (NAION), according to a study published online March 27 in JAMA Ophthalmology.
Alan Y. Hsu, M.D., from the China Medical University Hospital in Taichung City, Taiwan, and colleagues conducted a cohort study to examine the association between semaglutide use and risk for NAION among patients with diabetes. The semaglutide cohort was compared to a control group of randomly selected patients with diabetes who were prescribed non-glucagon-like peptide 1 (non-GLP-1) receptor agonist (RA) medications (174,584 patients in each group).
The researchers found that patients with diabetes taking semaglutide had an absence of NAION risk at the one-month, three-month, six-month, and one-year time points after the index date. However, at the two-year, three-year, and four-year time points from the index date, those taking semaglutide had an increased risk for NAION (hazard ratios, 2.39, 2.44, and 2.05, respectively). Patients with diabetes and concomitant hypertension who were taking semaglutide had an increased risk for NAION (hazard ratio, 2.42). Patients with diabetes who had a history of Ozempic use or stand-alone Ozempic prescription history also had increased NAION risk.
"Among patients with diabetes, an elevated risk of NAION was associated with semaglutide use compared with non-GLP-1 RA use," the authors write. "However, the study's retrospective design can only infer associations rather than establish causality."
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