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New research · Ophthalmology
The British journal of ophthalmology · 13h
Randomized trialThe British journal of ophthalmology · 2026

Non-arteritic anterior ischaemic optic neuropathy incidence in placebo-controlled clinical trials of liraglutide or semaglutide.

Tina Vilsbøll, Dikshit Arun Kumar, Lloyd Paul Aiello … Lars Michael Larsen
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OphthalmologyRandomized trial

NAION incidence not increased with GLP-1RA use versus placebo in trials.

Non-arteritic anterior ischaemic optic neuropathy incidence in placebo-controlled clinical trials of liraglutide or semaglutide.

Tina Vilsbøll … Lars Michael Larsen
The British journal of ophthalmology · 2026
Background

Risk of non-arteritic anterior ischaemic optic neuropathy (NAION) following exposure to glucagon-like peptide-1 receptor agonists (GLP-1RAs) in people with type 2 diabetes and/or obesity remains unclear.

Purpose

The aim of this study was to investigate NAION incidence across randomised placebo-controlled trials evaluating the GLP-1RAs liraglutide and semaglutide.

Methods

Pooled safety evaluation of NAION incidence from completed phase II, III and IV randomised placebo-controlled trials that evaluated the six Novo Nordisk-manufactured GLP-1RA products (active ingredients: liraglutide and semaglutide) in people with type 2 diabetes and/or overweight/obesity.

n = 829 participants
three cases per 100 000 PYO
Results
three cases per 100 000 PYO
GLP-1 users had lower, not higher, eye-nerve-damage rates than placebo
n = 829 participants
More results

This pooled analysis included 96 829 participants (GLP-1RA-treated: n=64 917; placebo-treated: n=31 912) with 205 777 participant-years of observation (participant-years of observation) (GLP-1RA-treated: 119 393 participant-years of observation; placebo-treated: 86 384 participant-years of observation).

More results

Across all trials, three confirmed NAION cases were identified in three GLP-1RA-treated participants and five confirmed cases were identified in four placebo-treated participants.

All ophthalmologist-confirmed cases reported one or more associated risk factors (eg, age >50 years, obesity, smoking, dyslipidaemia, hypertension).

“
Conclusion

Data from randomised placebo-controlled trials with semaglutide and liraglutide do not show an increased incidence of NAION in participants receiving GLP-1RA treatment versus those receiving placebo and, thus, do not suggest a relationship between GLP-1RA use and NAION.

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