Anterior ischemic optic neuropathy in patients treated with semaglutide: report of four cases with a possible association

Abstract Background Semaglutide, a glucagon-like peptide-1 receptor agonist, is increasingly used worldwide for its cardiometabolic benefits. However, it has recently been associated with nonarteritic anterior ischemic optic neuropathy (NAION). This report presents four clinical cases and explores a...

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Main Authors: Hamid Ahmadi, Steffen Hamann
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Ophthalmology
Subjects:
Online Access:https://doi.org/10.1186/s12886-025-03958-4
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author Hamid Ahmadi
Steffen Hamann
author_facet Hamid Ahmadi
Steffen Hamann
author_sort Hamid Ahmadi
collection DOAJ
description Abstract Background Semaglutide, a glucagon-like peptide-1 receptor agonist, is increasingly used worldwide for its cardiometabolic benefits. However, it has recently been associated with nonarteritic anterior ischemic optic neuropathy (NAION). This report presents four clinical cases and explores a possible association. Case presentation Four male patients were diagnosed with NAION during semaglutide treatment, with treatment durations of less than one year in three cases. All presented with significant optic disc edema and intraretinal fluid on optical coherence tomography, along with crowded optic disc and small Bruch’s membrane opening diameters (< 1.4 mm in three cases). One patient exhibited optic disc drusen. Visual field defects corresponded with ganglion cell layer atrophy on optical coherence tomography. Systemic risk factors varied; two patients had only obesity. Conclusions Our observation suggests that individuals with small Bruch’s membrane opening diameter may be at risk of developing NAION during semaglutide treatment.
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spelling doaj-art-6df193508a054978b1bfb375852fc04a2025-08-20T03:01:41ZengBMCBMC Ophthalmology1471-24152025-03-012511710.1186/s12886-025-03958-4Anterior ischemic optic neuropathy in patients treated with semaglutide: report of four cases with a possible associationHamid Ahmadi0Steffen Hamann1Department of Ophthalmology, Copenhagen University Hospital RigshospitaletDepartment of Ophthalmology, Copenhagen University Hospital RigshospitaletAbstract Background Semaglutide, a glucagon-like peptide-1 receptor agonist, is increasingly used worldwide for its cardiometabolic benefits. However, it has recently been associated with nonarteritic anterior ischemic optic neuropathy (NAION). This report presents four clinical cases and explores a possible association. Case presentation Four male patients were diagnosed with NAION during semaglutide treatment, with treatment durations of less than one year in three cases. All presented with significant optic disc edema and intraretinal fluid on optical coherence tomography, along with crowded optic disc and small Bruch’s membrane opening diameters (< 1.4 mm in three cases). One patient exhibited optic disc drusen. Visual field defects corresponded with ganglion cell layer atrophy on optical coherence tomography. Systemic risk factors varied; two patients had only obesity. Conclusions Our observation suggests that individuals with small Bruch’s membrane opening diameter may be at risk of developing NAION during semaglutide treatment.https://doi.org/10.1186/s12886-025-03958-4Semaglutidenonarteritic anterior ischemic optic neuropathycase-series.
spellingShingle Hamid Ahmadi
Steffen Hamann
Anterior ischemic optic neuropathy in patients treated with semaglutide: report of four cases with a possible association
BMC Ophthalmology
Semaglutide
nonarteritic anterior ischemic optic neuropathy
case-series.
title Anterior ischemic optic neuropathy in patients treated with semaglutide: report of four cases with a possible association
title_full Anterior ischemic optic neuropathy in patients treated with semaglutide: report of four cases with a possible association
title_fullStr Anterior ischemic optic neuropathy in patients treated with semaglutide: report of four cases with a possible association
title_full_unstemmed Anterior ischemic optic neuropathy in patients treated with semaglutide: report of four cases with a possible association
title_short Anterior ischemic optic neuropathy in patients treated with semaglutide: report of four cases with a possible association
title_sort anterior ischemic optic neuropathy in patients treated with semaglutide report of four cases with a possible association
topic Semaglutide
nonarteritic anterior ischemic optic neuropathy
case-series.
url https://doi.org/10.1186/s12886-025-03958-4
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AT steffenhamann anteriorischemicopticneuropathyinpatientstreatedwithsemaglutidereportoffourcaseswithapossibleassociation