Background: Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-RA), was introduced and approved by the United States Food and Drug Administration (FDA) for the management of type 2 diabetes ..
more »
Background: Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-RA), was introduced and approved by the United States Food and Drug Administration (FDA) for the management of type 2 diabetes in 2017. Since then, the medication has garnered much more attention for its ability to aid with weight loss. Until recently, the most significant side effects of semaglutide noted were mostly gastrointestinal symptoms such as nausea, vomiting, and diarrhea due to the drug’s mechanism of action of delayed gastric emptying. However, a singular cohort study from Harvard Medical School in conjunction with Massachusetts Eye and Ear of 16,827 patients recently suggested a possible risk of semaglutide and non-arteritic anterior ischemic optic neuropathy (NAION), a form of vision loss resulting from loss of blood flow to the optic nerve. Case Description: Here we report one case of semaglutide-associated vision loss in a middle-aged woman whose symptoms began roughly 2 months after discontinuing semaglutide due to intractable nausea. A 50-year-old woman with a past medical history of migraines, primary immune deficiency, asthma, and endometriosis presented with a recent diagnosis of Idiopathic Intracranial Hypertension and worsening symptoms. She stated that over the past two days, her right eye vision had gotten worse and reported being unable to see in the lower half of her visual field. Her headache was described as a pressure sensation radiating between her ears. On exam, the patient had horizontal nystagmus, difficulty converging, sluggish pupils, and difficulty visualizing anything below the level of the ceiling in her right eye. Left eye vision changes were not appreciable. Conclusion: Although causality has not been confirmed, there appears to be a correlation of semaglutide use with NAION, as observed in the study at Harvard Medical School and Massachusetts Eye and Ear, as well as in our patient. Therefore, further studies are recommended to assess the long-term risks associated with semaglutide, including NAION and other vision changes.
« less