Semaglutide Use and Risk of Diabetic Retinopathy and Non-Arteritic Anterior Ischemic Optic Neuropathy in Type 2 Diabetes: A Single-Center Retrospective Cohort Study.
Semaglutide and Eye Health: New Study Finds Zero NAION Cases Over Five Years
Clin Ophthalmol
by Kemchoknatee P, Pakaymaskul P, Piyawannarat N
“Semaglutide Use and Risk of Diabetic Retinopathy and Non-Arteritic Anterior Ischemic Optic Neuropathy in Type 2 Diabetes: A Single-Center Retrospective Cohort Study. Kemchoknatee P(1), Pakaymaskul P(1), Piyawannarat N(1). Author information: (1)Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand. BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs), including semaglutide, are increasingly adopted for type 2 diabetes mellitus (T2DM) due to improvements in glycemic control and weight loss. Although concerns have been raised about a potential association with non-arteritic anterior ischemic optic neuropathy (NAION), this relationship remains uncertain. OBJECTIVE AND METHOD: In this single-center retrospective cohort study, we reviewed patients with T2DM treated with semaglutide at Rajavithi Hospital. A Kaplan-Meier time-to-event analysis was conducted to estimate the incidence of NAION and proliferative diabetic retinopathy (PDR) progression. RESULTS: Among 100 patients with T2DM treated with semaglutide, no cases of NAION were observed over 299 person-years of follow-up (crude incidence rate: 0 per 1,000 person-years; 95% CI: 0-6.17). PDR and diabetic macular edema (DME) were the main findings, accounting for 10.00% and 3.00%, respectively. Ophthalmic complications group (13 patients) demonstrated higher body mass index (23.72 ± 1.38 vs 21.18 ± 2.51 kg/m2; p < 0.001), higher fasting plasma glucose (197.77 ± 48.28 vs 148.70 ± 27.84 mg/dL; p < 0.001), and worse baseline best-corrected visual acuity ([BCVA]; 1.71 ± 0.74 vs 0.45 ± 0.39 logarithm of the Minimum Angle of Resolution [logMAR]; p < 0.001). Final BCVA remained significantly worse in the complication group (p < 0.001). Ophthalmic complication remained stable over the 60-month follow-up; longer diabetes duration (>60 months) was modestly associated with better survival (log-rank p = 0.049). By contrast, other demographic, optic disc characteristics, and concomitant systemic vascular diseases were not significantly linked to ophthalmic complication. CONCLUSIONS: No NAION events were observed over 299 person-years; however, the limited sample size precludes definitive conclusions about NAION risk. A modest trend toward higher proliferative diabetic retinopathy rates suggests that ophthalmic monitoring may be warranted in at-risk patients. Larger prospective studies are needed to confirm these preliminary findings. © 2026 Kemchoknatee et al. PMCID: PMC13674446 Conflict of interest statement: The authors report no conflicts of interest in this work.”
Semaglutide continues to make waves as a research compound for type 2 diabetes. A fresh retrospective cohort study out of Rajavithi Hospital in Bangkok tracked 100 patients using semaglutide for diabetes management—focusing on two big concerns: non-arteritic anterior ischemic optic neuropathy (NAION) and diabetic eye disease.
Here’s the upshot. Over nearly 300 person-years of follow-up, researchers saw zero cases of NAION. That’s right—no one in this real-world group developed this feared optic nerve complication. The crude incidence rate comes out to 0 per 1,000 person-years. Not a huge sample, but that’s a solid signal for researchers paying attention to long-term ocular safety.
Other findings:
Proliferative diabetic retinopathy (PDR) showed up in 10% of patients. Diabetic macular edema (DME) in 3%.
Patients who did run into eye complications had higher BMI, higher fasting glucose, and worse vision at the start.
No clear link between complications and optic disc anatomy, other vascular diseases, or baseline demographics.
Over 60 months, the rate of complications stayed stable—nothing spiraled out of control.
So, what does this mean for the peptide research crowd? If you’re studying semaglutide and eye health, these data are a green flag, not a red one. The NAION scare didn’t pan out, at least in this group. The modest uptick in PDR is worth noting for anyone tracking retinal changes in at-risk populations, but nothing here screams halt-the-presses.
Key takeaway: Semaglutide holds up well for ocular safety in this Thai cohort. Of course, bigger studies are needed, but this is a strong start. If you’re sourcing research compounds for similar projects, check out the vendor directory for options.
No drama. Just another data point that keeps semaglutide firmly on the research radar.
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