Suspected Optic Nerve Dysfunction Associated with Semaglutide in a Non-Diabetic Obese Patient: A Case Report

Semaglutide Associated Optic Nerve Dysfunction

Abstract

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.