Abstract

Nonarteritic anterior ischemic optic neuropathy (NAION) is over hours or days progressive, mostly painless, and permanent visual impairment caused by ischemic damage to the optic nerve. The European Medicines Agency safety committee has currently listed NAION as a very rare side effect (incidence 1:10,000) of semaglutide. Semaglutide may increase the susceptibility to disease in patients with underlying risk factors predisposing them to NAION. The results of studies have been conflicting, and the topic requires further investigation. The current opinion is that, given the rare occurrence of the disease and the beneficial properties of GLP-1RAs such as blood sugar control, weight loss, cardio- and renoprotection, semaglutide should not be avoided purely because of the risk of NAION. However, if a diagnosis of NAION is confirmed, treatment with semaglutide should be stopped.