Eye and Semaglutide

Q: Ischemic optic neuropathy due to semaglutide is?

A) reversible

B) irreversible

Answer: B

The last decade has seen a tremendous rise in the use of Glucagon-like peptide 1 (GLP-1)-based therapies, which include GLP-1 receptor agonists, dual-acting GLP-1 and glucose-dependent insulinotropic polypeptide [GIP] receptor agonists. Unfortunately, the improper use of semaglutide has skyrocketed due to its property of quick weight loss.

Non-arteritic ischemic optic neuropathy (NAION) is a dreaded side effect of semaglutide, as it causes irreversible vision loss. Any patient who experiences worsening vision while taking semaglutide should discontinue it and consult their physician immediately.

# endocrinology

# ophthalmology

#pharmacology

References:

1. Grauslund J, Taha AA, Molander LD, et al. Once-weekly semaglutide doubles the five-year risk of nonarteritic anterior ischemic optic neuropathy in a Danish cohort of 424,152 persons with type 2 diabetes. Int J Retina Vitreous 2024; 10:97.

2. Hathaway JT, Shah MP, Hathaway DB, et al. Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide. JAMA Ophthalmol 2024; 142:732.

3. Natividade GR, Spiazzi BF, Baumgarten MW, et al. Ocular Adverse Events With Semaglutide: A Systematic Review and Meta-Analysis. JAMA Ophthalmol 2025; 143:759.