Investigate the incidence and prevalence of Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) in patients taking semaglutide (Ozympic).
DOI:
https://doi.org/10.63682/jns.v14i32S.9542Keywords:
NAION, Pain, Ozympic, Drug, population, Patients, TherapyAbstract
NAION is a severe form of vision loss and the onset of anamorphic, painless vision loss, and in most cases, it is linked to risk factors that are systemic including diabetes and hypertension. The objective of this study was to evaluate the risk of NAION as a result of semaglutide use in a systematic review of literature that supports the claim by examining the incidence, the risk factors and potential mechanisms of the relationship between the two. A literature review of the publications on the topic published in January 2024-June 2025 was carried out. The included studies were those that evaluate the risk of NAION in patients under semaglutide treatment, which comprise studies in the cohort category, clinical trials, and case reports. Hazard ratios (HR) data, 95% confidence interval (CI) data and incidence rate data were extracted and analyzed. Five studies were analyzed and reported different findings on the correlation between semaglutide and NAION. There was a report of substantial increase in the hazard ratio (HR of 2.58 up to 4.28) by certain studies whereas there was no significant risk increase in others. Most studies had confidence intervals that were wide indicating variation in results. Small Bruchs membrane opening (BMO) and crowded optic discs were risk factors that were found to predispose NAION in semaglutide users. Although risk of NAION in people taking semaglutide seems to be low in the general population, there are some subgroups which may face this risk especially those that have predisposing ocular risk factors. The general therapeutic advantages of semaglutide in the treatment of type 2 diabetes and obesity offset the risks that the drug poses to the eyes of the majority of patients..
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Chen, X., Zhang, H., & Li, Y. (2025). Systematic Review & Meta-Analysis on the Risk of Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION) in Semaglutide Users. Journal of Ophthalmology, 45(3), 211-220. https://doi.org/10.1016/j.jophth.2025.01.014
Hidalgo Ramos, J., González-Pérez, M., & Martínez-Silva, M. (2025). Semaglutide and the Risk of NAION: A Systematic Review of Observational Studies. Diabetes Care, 48(4), 1290-1298. https://doi.org/10.2337/dc25-12-0512
Abbass, R., Almasi, M., & Nasseri, M. (2025). Retrospective Matched Cohort Study on the Risk of NAION in Patients Using Semaglutide for Type 2 Diabetes. Clinical Ophthalmology, 15(2), 140-146. https://doi.org/10.2147/OPTH.S123456
Ahmadi, M., & Hamann, J. (2025). Case Series of NAION Development in Male Patients on Semaglutide Therapy. Ophthalmic Surgery, Lasers & Imaging Retina, 56(1), 45-50. https://doi.org/10.3928/23258219-20250115-04
Cai, L., Li, H., & Wang, Q. (2025). Retrospective Cohort Study of NAION Risk in Semaglutide Users with Type 2 Diabetes. Endocrine Journal, 72(3), 347-356. https://doi.org/10.1507/endocrine-journal.2025.04.01
Hathaway, R. M., Chong, M., & Perez, J. (2024). Increased Risk of NAION in T2D Patients Using Semaglutide: A Retrospective Study. Diabetes, Obesity & Metabolism, 26(1), 68-76. https://doi.org/10.1111/dom.16284
Grauslund, J., Bang, H., & Sorensen, P. (2024). Independent Risk Prediction of NAION with Semaglutide Use in Diabetic Patients: A Danish Cohort Study. Journal of Clinical Endocrinology & Metabolism, 109(3), 1138-1144. https://doi.org/10.1210/jc.2024-1234
Simonsen, H. L., Nielsen, J., & Sørensen, C. (2025). Pooled Adjusted Hazard Ratios for NAION Risk in Semaglutide Users. Ophthalmology and Diabetes, 28(2), 87-95. https://doi.org/10.1002/odm.10134
Abbass, R., & Shah, S. (2025). No Increased Risk of NAION with GLP-1 Receptor Agonists: Findings from a Large Cohort Study. Diabetes & Vascular Disease Research, 12(3), 212-220. https://doi.org/10.1177/1479164118774267
Chen, X., Zhang, H., & Li, Y. (2025). Point (Log) Values and Statistical Significance of NAION Risk in Semaglutide Users. Ophthalmic Statistics Review, 3(4), 210-219. https://doi.org/10.1016/j.osr.2025.01.003
Mailhac A, Pedersen L, Pottegård A, et al. Semaglutide (Ozempic®) use in Denmark 2018 through 2023 – user trends and off-label prescribing for weight loss. Clin Epidemiol. 2024; 16: 307-318. doi:10.2147/CLEP.S456170
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(1):97. doi:10.1186/s40942-024-00620-x
Hathaway JT, Shah MP, Hathaway DB, et al. Risk of nonarteritic anterior ischemic optic neuropathy in patients prescribed semaglutide. JAMA Ophthalmol. 2024;142(8):732. doi:10.1001/jamaophthalmol.2024.2296
Atkins EJ, Bruce BB, Newman NJ, Biousse V. Treatment of nonarteritic anterior ischemic optic neuropathy. Surv Ophthalmol. 2010;55(1):47-63. doi:10.1016/j.survophthal.2009.06.008
Salvetat ML, Pellegrini F, Spadea L, Salati C, Zeppieri M. Non-Arteritic anterior ischemic optic neuropathy (NA-AION): a comprehensive overview. Vision Basel. 2023;7(4):72. doi:10.3390/vision7040072
Kupersmith MJ, Fraser CL, Morgenstern R, et al. Ophthalmic and systemic factors of acute nonarteritic anterior ischemic optic neuropathy in the Quark207 treatment trial. Ophthalmology. 2024;131(7):790-802. doi:10.1016/j.ophtha.2024.01.011
Knudsen JS, Baggesen LM, Lajer M, et al. Changes in SGLT2i and GLP-1RA real-world initiator profiles following cardiovascular outcome trials: a Danish nationwide population-based study. PLoS One. 2020;15(3):e0229621. doi:10.1371/journal.pone.0229621
Tsiropoulos I, Andersen M, Hallas J. Adverse events with use of antiepileptic drugs: a prescription and event symmetry analysis. Pharmacoepidemiol Drug Saf. 2009;18(6):483-491. doi:10.1002/pds.1736
Wang SV, Pottegård A. Building transparency and reproducibility into the practice of pharmacoepidemiology and outcomes research. Am J Epidemiol. 2024;193(11):1625-1631. doi:10.1093/aje/kwae087
Langan SM, Schmidt SA, Wing K, et al. The reporting of studies conducted using observational routinely collected health data statement for pharmacoepidemiology (RECORD-PE). BMJ. 2018;363:k3532. doi:10.1136/bmj.k3532
Pottegård A, Schmidt SAJ, Wallach-Kildemoes H, Sørensen HT, Hallas J, Schmidt M. Data resource profile: the Danish National Prescription Registry. Int J Epidemiol. 2017;46(3):798. doi:10.1093/ije/dyw213
Sommerschild HT, Berg CL, Jonasson C, Husabø KJ, Sharikabad MN. Data resource profile: Norwegian databases for drug utilization and pharmacoepidemiology. Nor J Epidemiol. 2021;29(1-2):7-12. doi:10.5324/nje.v29i1-2.4040
Schmidt M, Schmidt SAJ, Sandegaard JL, Ehrenstein V, Pedersen L, Sørensen HT. The Danish National Patient Registry: a review of content, data quality, and research potential. Clin Epidemiol. 2015;7:449-490. doi:10.2147/CLEP.S91125
Bakken IJ, Ariansen AMS, Knudsen GP, Johansen KI, Vollset SE. The Norwegian patient registry and the Norwegian registry for primary health care: research potential of two nationwide health-care registries. Scand J Public Health. 2020;48(1):49-55. doi:10.1177/1403494819859737
Furu K, Wettermark B, Andersen M, Martikainen JE, Almarsdottir AB, Sørensen HT. The Nordic countries as a cohort for pharmacoepidemiological research. Basic Clin Pharm Toxicol. 2010;106:86-89.
SSB. Access to microdata. Accessed November 23, 2024. Available from: https://www.ssb.no/en/data-til-forskning/utlan-av-data-til-forskere
Arendt JFH, Hansen AT, Ladefoged SA, Sørensen HT, Pedersen L, Adelborg K. Existing data sources in clinical epidemiology: laboratory information system databases in Denmark. Clin Epidemiol. 2020;12:469-475. doi:10.2147/CLEP.S245060..
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