Semaglutide May Increase Risk for Nonarteritic Anterior Ischemic Optic Neuropathy

MONDAY, Feb. 23, 2026 (HealthDay News) — People with type 2 diabetes starting semaglutide have more than a doubled risk for nonarteritic anterior ischemic optic neuropathy (NAION) versus those starting sodium-glucose cotransporter-2 inhibitors (SGLT2is), according to a brief report published online Feb. 12 in JAMA Ophthalmology.

Kent Heberer, Ph.D., from the VA Palo Alto Healthcare System in California, and colleagues evaluated whether semaglutide is associated with an increased risk for the incidence of NAION compared with SGLT2i in patients with type 2 diabetes. The analysis included 11,478 U.S. veterans initiating semaglutide and 90,883 initiating SGLT2is.

The researchers found that during a maximum follow-up of 7.5 years, the incidence rate of NAION was 123 per 100,000 person-years among semaglutide initiators and 67 per 100,000 person-years among SGLT2i initiators. At a median follow-up of 2.1 years, semaglutide initiators had a 2.33-fold higher risk than SGLT2i initiators. For semaglutide initiators, the overlap weighted incidence rate of NAION was 0.29 percent versus 0.13 percent for SGLT2i initiators.

“In this nationwide cohort of U.S. veterans with T2D, semaglutide initiators had a twofold [higher] NAION risk than SGLT2i initiators, while the absolute risk was low,” the authors write. “Clinicians and patients should be counseled on the rare but evident increased risk of NAION after semaglutide initiation.”

Three authors disclosed ties to the biopharmaceutical industry.

Abstract/Full Text