Semaglutide, type 2 diabetes, and the risk of nonarteritic anterior ischemic optic neuropathy

In the last months, conflicting evidence on a possible association between the use of semaglutide and incident nonarteritic anterior ischemic optic neuropathy (NAION) has emerged. A recently published study, which evaluated all patients with type 2 diabetes in Denmark, has shown with robustness that...

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Detalles Bibliográficos
Autores: Malerbi, Fernando Korn, Bertoluci, Marcello Casaccia
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:Brasil
Institución:Universidade Federal do Rio Grande do Sul (UFRGS)
Repositorio:Repositório Institucional da UFRGS
Idioma:inglés
OAI Identifier:oai:www.lume.ufrgs.br:10183/287450
Acceso en línea:http://hdl.handle.net/10183/287450
Access Level:acceso abierto
Palabra clave:Peptídeos semelhantes ao glucagon
Diabetes mellitus tipo 2
Hipoglicemiantes
Neuropatia óptica isquêmica
Type 2 diabetes
Semaglutide
Nonarteritic anterior ischemic optic neuropathy
Descripción
Sumario:In the last months, conflicting evidence on a possible association between the use of semaglutide and incident nonarteritic anterior ischemic optic neuropathy (NAION) has emerged. A recently published study, which evaluated all patients with type 2 diabetes in Denmark, has shown with robustness that once-weekly semaglutide doubles the five-year risk of NAION. In this comment, the new evidence is discussed, along with practical implications for type 2 diabetes patients. The possibility of ophthalmological evaluation regarding optic disc morphology is suggested, before initiation of semaglutide treatment or, for those patients already under treatment, during a follow-up ophthalmological visit. If a disc-at-risk pattern is detected, such information could be brought to the attention of the attending clinician involved with diabetes control and discussed with patients for a shared decision-making approach. A new risk-benefit discussion weighing the undoubted benefits of semaglutide in reducing cardiovascular mortality and cardiovascular events, heart failure hospitalization, and renal protection must be started and carefully balanced against a rare but devastating condition such as NAION.