Suspected Optic Nerve Dysfunction Associated with Semaglutide in a Non-Diabetic Obese Patient: A Case Report
Semaglutide Associated Optic Nerve Dysfunction
DOI:
https://doi.org/10.66381/jod.2026.002Keywords:
Semaglutide, GLP-1 receptor agonist, optic neuropathy, blurred vision, obesity, vasculitisAbstract
Background: Semaglutide, a glucagon-like peptide-1 receptor agonist, is widely used for the treatment of type 2 diabetes mellitus and obesity. Although its safety profile is well established for common adverse effects, reports of neuro-ophthalmic complications remain limited.
Case Presentation: A middle-aged non-diabetic obese man with a history of non-specific vasculitis and chronic lymphedema developed persistent bilateral blurred vision after initiation of semaglutide for weight management. He had no prior history of hypertension, dyslipidemia, or ocular disease. Comprehensive ophthalmologic examination was normal. Despite discontinuation of semaglutide, visual symptoms persisted. Neurologic evaluation raised concern for optic nerve involvement, although neuroimaging was inconclusive.
Outcome: The temporal association with semaglutide exposure and the absence of alternative causes suggested a possible drug-associated neuro-ophthalmic adverse effect. The patient experienced psychological distress related to persistent visual impairment and weight regain.
Conclusion: This case highlights a potential association between semaglutide therapy and optic nerve–related visual disturbance in a non-diabetic patient. Clinicians should consider neuro-ophthalmic evaluation in patients receiving GLP-1 receptor agonists who develop new visual symptoms.
Downloads
References
1. Wharton S, Freitas P, Hjelmesæth J, Kabisch M, Kandler K, Lingvay I, Quiroga M, Rosenstock J, Garvey WT. Once-weekly semaglutide 7· 2 mg in adults with obesity (STEP UP): a randomised, controlled, phase 3b trial. The Lancet Diabetes & Endocrinology. 2025 Nov 1;13(11):949-63. doi:10.1016/S2213-8587(25)00226-8
2. Wang L, Volkow ND, Kaelber DC, Xu R. Semaglutide or tirzepatide and optic nerve and visual pathway disorders in type 2 diabetes. JAMA Network Open. 2025 Aug 11;8(8):e2526327. doi:10.1001/jamanetworkopen.2025.26327
3. Cai CX, Hribar M, Baxter S, Goetz K, Swaminathan SS, Flowers A, Brown EN, Toy B, Xu B, Chen J, Chen A. Semaglutide and nonarteritic anterior ischemic optic neuropathy. JAMA ophthalmology. 2025 Apr;143(4):304-14. doi:10.1001/jamaophthalmol.2024.6555
4. Chen B, Tao L, Tian M, Ji Z. Efficacy and safety of combination of semaglutide and basal insulin in patients with of type 2 diabetes mellitus: A systematic review and meta-analysis. Clinical Nutrition ESPEN. 2025 Jan 30. https://doi.org/10.1016/j.clnesp.2025.01.056
5. Salvador R, Moutinho CG, Sousa C, Vinha AF, Carvalho M, Matos C. Semaglutide as a GLP-1 agonist: A breakthrough in obesity treatment. Pharmaceuticals. 2025 Mar 12;18(3):399.
doi:10.3390/ph18030399
6. Feng JN, Chen Y, Jin T. GLP-1 medicine and nonarteritic anterior ischemic optic neuropathy: literature review and perspectives. Metabolism and Diseases. 2025 Dec 8:100001. https://doi.org/10.1016/j.metdis.2025.100001
7. West J, Li M, Wong S, Le GH, Teopiz KM, Valentino K, Dri CE, McIntyre RS. Are Glucagon-Like Peptide-1 Receptor Agonists Central Nervous System Penetrant: A Narrative Review. Neurology and therapy. 2025 Apr 2:1-0. DOI: 10.1007/s40120-025-00724-y
8. Eggenberger E. Optic neuritis. CONTINUUM: Lifelong Learning in Neurology. 2025 Apr 1;31(2):407-35. https://doi.org/10.1212/cont.0000000000001556
9. Gong X, Örge FH. Glucagon-like Peptide-1 Receptor Agonists and Ocular Disease: Mechanisms, Evidence and Therapeutic Perspectives. https://doi.org/10.3390/ijms27031432
10. West S, Scragg J, Aveyard P, Oke JL, Willis L, Haffner SJ, Knight H, Wang D, Morrow S, Heath L, Jebb SA. Weight regain after cessation of medication for weight management: systematic review and meta-analysis. bmj. 2026 Jan 7;392. doi: https://doi.org/10.1136/bmj-2025-085304
Published
Data Availability Statement
All data generated or analyzed during this case report are included in this published article. No additional datasets were generated or analyzed.
License
Copyright (c) 2026 Journal of Diabesity
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles published in the Journal of Diabesity (JOD) are licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0).
What this means:
Under the CC BY 4.0 license, authors retain copyright of their work, while allowing others to:
-
Share — Copy and redistribute the material in any medium or format
-
Adapt — Remix, transform, and build upon the material for any purpose, even commercially
Conditions:
Users must provide appropriate attribution to the original author(s) and source, including:
-
The article title
-
Author(s) name(s)
-
Journal name (Journal of Diabesity)
-
DOI or link to the original article
-
An indication if changes were made
There is no restriction on commercial use or derivative works, as long as proper attribution is given.
Full License Text:
https://creativecommons.org/licenses/by/4.0/
✍️ Author Rights:
-
Authors retain copyright and grant JOD the right of first publication.
-
Authors may archive the published version in institutional repositories, personal websites, or other platforms with proper citation.
