Semaglutide increases the risk of non-arteritic anterior ischaemic optic neuropathy (NAION).
- Current status
- Evidence of harmEvidence strengthening · Ophthalmologic
- Why
- A single-centre neuro-ophthalmology cohort first reported HR 4.28 (T2D) and higher in obesity; a 2026 meta-analysis of observational studies found HR ~2.2 with very low absolute risk (~1 extra case per 7,000 treated per year). The meta-analysis authors note consistency with regulatory communications. Observational evidence; causality not proven; rare but irreversible.
- What would change it
- Adjudicated ophthalmologic outcomes from RCT datasets; dose-response or mechanism data.
- Linked studies
- 2 · 2 supports
- Last updated
- Sep 13, 2026
The status is the collection's own judgment on its assessment scale, not a GRADE certainty rating and not medical advice.
01The evidence
The evidence, sorted by what it shows
Supports (2)
- Semaglutide-associated risk of nonarteritic anterior ischemic optic neuropathy in patients with type 2 diabetes: A systematic review and meta-analysis of observational studiesMeta-analysis · 2026 · Study tier 3 · Different population · Harm direction
Meta-analysis of 5 observational studies: HR 2.17; absolute risk 0.014%/year.
- Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed SemaglutideRetrospective cohort · 2024 · Study tier 4 · Different population · Harm direction
Retrospective matched cohort, single centre; small event numbers; referral population.
02History
How this assessment has changed
- Evidence of harmSep 13, 2026 · Evidence strengthening
initial curated status