ArticleDiabetes, obesity & metabolism2026
GLP-1RA and the risk of non-arteritic anterior ischaemic optic neuropathy in patients with type 2 diabetes: A population-based study.
Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Semaglutide-associated risk of nonarteritic anterior ischemic optic neuropathy in patients with type 2 diabetes: A systematic review and meta-analysis of observational studies.PLoS medicine · 2026 · on this mapPooled it
- Causes and consequences of discontinuation of GLP1RAs or tirzepatide.Nature reviews. Endocrinology · 2026Review
- Glucagon-Like Peptide-1 Receptor Agonists and Ocular Outcomes: Metabolic Transition, Retinal Vulnerability, and Risk-Stratified Monitoring.Journal of obesity & metabolic syndrome · 2026Review
- Risk of Non-Arteritic Anterior Ischemic Optic Neuropathy in Idiopathic Intracranial Hypertension Patients Treated with GLP-1 Receptor Agonists.Annals of clinical and translational neurology · 2026Article
Corrections and comments
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Authors and funding
8 authors.
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Abstract
aimsEvidence on the safety of semaglutide and other glucagon-like peptide-1 receptor agonists (GLP-1RA) concerning non-arteritic anterior ischemic optic neuropathy (NAION) is inconclusive, with several studies published to date presenting methodological challenges. We sought to compare the risk of presumed NAION in patients with type 2 diabetes (T2D), initiating a GLP-1RA versus a sodium-glucose cotransporter-2 inhibitor (SGLT2i), using a new-user active comparator cohort study design within a target trial emulation framework. MATERIALS AND
methodsUsing insurance claims data from three databases (01/2016-08/2024), we identified 482 912 propensity score matched (1:1) pairs of GLP-1RA and SGLT2i adult initiators with T2D and without prior ischemic optic neuropathy (ION) or other optic nerve disorders. NAION was defined as a diagnosis of ION without other causes of optic neuropathy, combined with an ophthalmologist or optometrist visit on the same day. We estimated pooled hazard ratios (HRs) and rate differences (RDs).
resultsOver a median follow-up of 6.7 months on treatment, the risk of incident NAION was higher among initiators of GLP-1RA compared with SGLT2i [HR, 1.85; 95% CI (1.51-2.27); RD, 0.29 (0.19, 0.39) per 1000 person-years]. Results were consistent across subgroups and sensitivity analyses. A meta-analysis of our semaglutide analysis with previously published results also showed an elevated risk, with a HR of 2.78 (1.39-5.56).
conclusionsIn this large observational study, the initiation of GLP-1RA was associated with an 85% increase in the risk of presumed NAION, compared with the initiation of SGLT2is, though incidence rates and absolute increase in risk were small.
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