Glucagon-like Peptide-1 Receptor Agonists and Risk of Nonarteritic Anterior Ischemic Optic Neuropathy: Systematic Review and Meta-Analysis.

Dhivagaran T, Butt F, Arunasalam L, Bae I, Mikhail D, Tao BK, Xie JS, Balas M, Popovic M, Margolin E

Neurology30 Apr 2026Cited by 2 (Europe PMC)

PMID42060879DOI10.1212/wnl.0000000000214864PepBankPUB-42060879

Publisher page PubMedAsk about this study

Summary

The text of this summary is not shown here, because the article license does not allow reuse. Read it at the source (opens in a new tab)

Text rights: Publisher copyright. Results still quote short attributed sentences.

Results from this study4

3 results from studies that gave the peptide. 3 results from people.

01HumanSystematic reviewSafety outcome
In a meta-analysis of five studies, semaglutide use was associated with a higher risk of NAION than non-GLP-1RA use.
In plain wordsIn a pooled analysis of five studies, semaglutide use was linked to a higher risk of an eye nerve condition, NAION, than no GLP-1 drug.
Peptide
Semaglutide
Outcome
IncreaseRisk of nonarteritic anterior ischemic optic neuropathy (NAION)
Study
n = 1,593,554
Comparator
Non-GLP-1RA users
Outcome group
Adverse events · Eye
Studied dose
Dose not stated
Measurements
Relative risk
2.52
semaglutide vs non-GLP-1RA, 95% CrI 1.56-4.72
Source sentences
Summary
Semaglutide use was associated with a high probability of increased risk of NAION compared with non-GLP-1RA use (RR: 2.52, 95% CrI [1.56, 4.72], I²: 57.8%, P(RR > 1): 99.9%).
2 context sentences(design, population, supporting numbers)
Summary · context
Five studies were included in the primary analysis, encompassing 1,593,554 patients (682,456 semaglutide users and 911,098 non-GLP-1RA users).
Summary · context
Observational studies and randomized controlled trials comparing NAION risk in GLP-1RA users with non-GLP-1RA users were included.
Report a problemFND-4206087901
02HumanSystematic reviewSafety outcome
Across 1,108,542 semaglutide users, the pooled incidence of NAION was 118 cases per 100,000.
In plain wordsAmong semaglutide users in five pooled studies, the rate of the eye nerve condition NAION was 118 cases per 100,000.
Peptide
Semaglutide
Outcome
Not applicableNAION incidence in semaglutide users
Study
n = 1,108,542
Outcome group
Adverse events · Eye
Studied dose
Dose not stated
Measurements
NAION incidence
118 per 100,000
semaglutide users, 95% CrI 32-451
Source sentences
Summary
The incidence of NAION across 1,108,542 semaglutide users was 118 cases per 100,000 (95% CrI [32, 451], I²: 98.8%, P(incidence >0.00001): 100%).
1 context sentence(design, population, supporting numbers)
Summary · context
Observational studies and randomized controlled trials comparing NAION risk in GLP-1RA users with non-GLP-1RA users were included.
Report a problemFND-4206087903
03HumanSystematic reviewSafety outcome
In patients with diabetes, semaglutide use was associated with a higher risk of NAION than non-GLP-1RA use.
In plain wordsIn patients with diabetes, semaglutide use was linked to a higher risk of an eye nerve condition, NAION, than no GLP-1 drug.
Peptide
Semaglutide
Outcome
IncreaseNAION risk in patients with diabetes
Study
n: not reported in source
Comparator
Non-GLP-1RA users
Outcome group
Adverse events · Eye
Studied dose
Dose not stated
Measurements
Relative risk
2.41
diabetes subgroup, 95% CrI 1.57-4.10
Source sentences
Summary
This association was particularly pronounced among patients with diabetes (RR: 2.41, 95% CrI [1.57, 4.10], I²: 47.2%, P(RR > 1): 99.9%).
1 context sentence(design, population, supporting numbers)
Summary · context
Observational studies and randomized controlled trials comparing NAION risk in GLP-1RA users with non-GLP-1RA users were included.
Report a problemFND-4206087902

Studies that did not test the peptide alone1

In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking Semaglutide.

04HumanNot a test of Semaglutide aloneSystematic reviewSafety outcome
Across pooled users of semaglutide, dulaglutide and exenatide, the overall incidence of NAION was 85 cases per 100,000.
In plain wordsAmong users of three GLP-1 drugs pooled together, the rate of the eye nerve condition NAION was 85 cases per 100,000.
Peptide
Semaglutide
Outcome
Not applicableNAION incidence in pooled GLP-1RA users
Study
n = 1,460,760
Outcome group
Adverse events · Eye
Measurements
NAION incidence
85 per 100,000
pooled GLP-1RA users, 95% CrI 29-263
Source sentences
Summary
The overall incidence of NAION across 5 studies and 7 comparisons, encompassing 1,460,760 patients (semaglutide: 1,108,542; dulaglutide: 326,282; and exenatide: 25,936) and 272 NAION events (semaglutide: 198; dulaglutide: 54; and exenatide: 20) was 85 cases per 100,000 GLP-1RA users (95% CrI [29, 26…
1 context sentence(design, population, supporting numbers)
Summary · context
Observational studies and randomized controlled trials comparing NAION risk in GLP-1RA users with non-GLP-1RA users were included.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Report a problemFND-4206087904

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
11 Oct 2026, 00:04 UTC
Study results updated
Version 1
9 Oct 2026, 03:06 UTC
First added · source update from Europe PMC

Subjects

Terms as the source lists them.

Publication types

MeSH terms

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