JAMA Ophthalmol

Semaglutide initiation linked to doubled risk of rare optic neuropathy in US veterans

February 17, 2026

A target trial emulation of 102,361 US veterans with T2DM found that semaglutide initiation was associated with more than double the risk of new-onset nonarteritic anterior ischemic optic neuropathy compared with SGLT2 inhibitor initiation (hazard ratio, 2.33; 95% confidence interval, 1.54–3.54) over a median 2.1-year follow-up. However, absolute risk remained low (0.29% vs 0.13%, respectively).

Clinical takeaway: Counsel semaglutide users to report any sudden visual changes promptly, and weigh therapy choices carefully in patients with preexisting optic nerve risk factors.

Source:

Heberer K, et al. (2026, February 12). JAMA Ophthalmol. New-Onset Nonarteritic Anterior Ischemic Optic Neuropathy and Initiators of Semaglutide in US Veterans With Type 2 Diabetes. https://pubmed.ncbi.nlm.nih.gov/41678180/