Is Semaglutide Use Associated with Nonarteritic Anterior Ischemic Optic Neuropathy?

Nonarteritic anterior ischemic optic neuropathy (NAION) is a rare cause of optic neuropathy that can result in blindness. A recent study suggested an association between NAION and glucagon-like peptide-1 (GLP-1)–receptor agonist semaglutide in an ophthalmology referral population (NEJM JW Gen Med Aug 15 2024 and JAMA Ophthalmol 2024; 142:732). To examine a potential association in the general population, researchers evaluated 14 U.S. databases with information on 37 million patients with type 2 diabetes who used semaglutide or other common diabetes medications. Two study designs were used to help limit confounding: A new-user cohort (800,000 patients) with propensity-score matching and a self-controlled case series (40,000 patients).

In the …