New-Onset Nonarteritic Anterior Ischemic Optic Neuropathy and Initiators of Semaglutide in US Veterans With Type 2 Diabetes

Is semaglutide associated with an increased risk of incidence of nonarteritic anterior ischemic optic neuropathy (NAION) compared with sodium-glucose cotransporter-2 inhibitors (SGLT2i) in patients with type 2 diabetes?In this study, among a group of US veterans with type 2 diabetes, initiation of semaglutide was associated with a 2-fold higher risk of incident NAION compared with initiation of an SGLT2i, with overlap weighted cumulative risks of 0.29% vs 0.13% over a median follow-up of 2.1 years.While absolute incidence of NAION is low in patients initiating semaglutide, medical counseling about this potential complication, which can result in substantial loss of vision, may be warranted.

Corresponding Author: Jennifer S. Lee, MD, PhD, VA Palo Alto Health Care System, Research Administration Office, Bldg 710, 3801 Miranda Ave, Palo Alto, CA 94034 (jennifer.lee23@va.gov).

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