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New research · Ophthalmology
Annals of clinical and translational neurology · 1d
Cohort studyAnnals of clinical and translational neurology · 2026

Risk of Non-Arteritic Anterior Ischemic Optic Neuropathy in Idiopathic Intracranial Hypertension Patients Treated with GLP-1 Receptor Agonists.

Faisal A Al-Harbi, Mohanad A Alkuwaiti, Yazeed B Alaql … Ahmed Y Azzam
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OphthalmologyCohort study

GLP-1 receptor agonist use linked to lower risk of optic nerve stroke in intracranial hypertension patients

Risk of Non-Arteritic Anterior Ischemic Optic Neuropathy in Idiopathic Intracranial Hypertension Patients Treated with GLP-1 Receptor Agonists.

Faisal A Al-Harbi … Ahmed Y Azzam
Annals of clinical and translational neurology · 2026
Background

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated significant weight-reducing effects and may offer benefits in idiopathic intracranial hypertension (intracranial hypertension); however, recent concerns about the risk of non-arteritic anterior ischemic optic neuropathy (NAION) have emerged.

Methods

This study used the TriNetX Global Collaborative Network to perform a retrospective propensity score-matched cohort study.

Results

GLP-1 drug users were about half as likely to develop optic nerve stroke

RR by subgroup · 95% CI
null = 1
non-diabetic patients
0.53
compared to diabetic patients
0.76
More results

Time-stratified analyses have demonstrated protective associations across all evaluated time windows.

The optic atrophy finding remained significant after Bonferroni correction, while NAION remained significant after false discovery rate correction.

More results

Subgroup analysis revealed stronger protective associations in non-diabetic patients (risk ratio 0.53, 95% CI 0.41-0.68) compared to diabetic patients (risk ratio 0.76, 95% CI 0.58-0.99).

“
Conclusion · 1 of 2

GLP-1 RA utilization among intracranial hypertension patients was associated with a reduced risk of NAION and optic atrophy.

Conclusion · 2 of 2

These findings align with the proposed pathway linking GLP-1 RA-induced weight reduction to lower intracranial pressure and papilledema reduction in intracranial hypertension patients; residual confounding cannot be ruled out, and prospective studies are needed to confirm these associations.

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