{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T07:16:45Z","timestamp":1783322205634,"version":"3.54.6"},"reference-count":19,"publisher":"The Endocrine Society","issue":"7","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), is widely used to manage type 2 diabetes and obesity. Recent pharmacovigilance signals have reported an increased incidence of nonarteritic anterior ischemic optic neuropathy (NAION) among semaglutide users, although the absolute risk remains low. We report a man in his early 30s with class III obesity, obstructive sleep apnea, and prediabetes who developed acute, painless, asymmetric bilateral visual dysfunction four weeks after semaglutide escalation to 1 mg per week. Evaluation revealed retrobulbar optic neuropathy with asymmetric visual field defects, a central scotoma in the left eye, an altitudinal defect in the right eye, preserved optic disc appearance, and markedly delayed visual evoked potentials. Optical coherence tomography and neuroimaging were unremarkable. The presentation was atypical for NAION but did not fully align with classical demyelinating optic neuritis, yielding a mixed clinical picture. Semaglutide was discontinued immediately, and visual function remained stable over serial follow-up with adaptation to a persistent left central scotoma but no further deterioration. This case illustrates an atypical retrobulbar optic neuropathy in close temporal proximity to semaglutide dose escalation and underscores the need for clinical vigilance and strengthened pharmacovigilance as GLP-1RA use expands globally.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag108","type":"journal-article","created":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T11:36:58Z","timestamp":1775302618000},"source":"Crossref","is-referenced-by-count":1,"title":["Atypical retrobulbar optic neuropathy after semaglutide escalation"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2847-1747","authenticated-orcid":false,"given":"Shivaprasad","family":"Channabasappa","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Sapthagiri Institute of Medical Sciences and Research Centre , Bengaluru 560090 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riddhi Das","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sapthagiri Institute of Medical Sciences and Research Centre , Bengaluru 560090 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidhya","family":"Chandran","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Sankara Eye Hospital , Bengaluru 560037 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sai","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, S. Nijalingappa Medical College and HSK Hospital and Research Centre , Bagalkot 587102 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"issue":"9","key":"2026070603020301000_luag108-B1","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1001\/jamaophthalmol.2025.2489","article-title":"Ocular adverse events with semaglutide: a systematic review and meta-analysis","volume":"143","author":"Natividade","year":"2025","journal-title":"JAMA Ophthalmol"},{"issue":"1","key":"2026070603020301000_luag108-B2","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1186\/s12886-025-03958-4","article-title":"Anterior ischemic optic neuropathy in patients treated with semaglutide: report of four cases with a possible association","volume":"25","author":"Ahmadi","year":"2025","journal-title":"BMC Ophthalmol"},{"issue":"4","key":"2026070603020301000_luag108-B3","doi-asserted-by":"crossref","first-page":"NP10","DOI":"10.1177\/11206721251331655","article-title":"Non-arteritic ischemic optic neuropathy in a patient taking semaglutide: is there a relation? A case report and review of the literature","volume":"35","author":"Maceroni","year":"2025","journal-title":"Eur J Ophthalmol"},{"key":"2026070603020301000_luag108-B4","doi-asserted-by":"crossref","first-page":"618353","DOI":"10.3389\/fmed.2021.618353","article-title":"Risk factors for non-arteritic anterior ischemic optic neuropathy: a large scale meta-analysis","volume":"8","author":"Liu","year":"2021","journal-title":"Front Med (Lausanne)"},{"issue":"6","key":"2026070603020301000_luag108-B5","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1111\/aos.17473","article-title":"Semaglutide and non-arteritic anterior ischaemic optic neuropathy: review and interpretation of reported association","volume":"103","author":"Amini","year":"2025","journal-title":"Acta Ophthalmol"},{"issue":"8","key":"2026070603020301000_luag108-B6","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1001\/jamaophthalmol.2024.2296","article-title":"Risk of nonarteritic anterior ischemic optic neuropathy in patients prescribed semaglutide","volume":"142","author":"Hathaway","year":"2024","journal-title":"JAMA Ophthalmol"},{"issue":"1","key":"2026070603020301000_luag108-B7","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1186\/s40942-024-00620-x","article-title":"Once-weekly semaglutide doubles the five-year risk of nonarteritic anterior ischemic optic neuropathy in a Danish cohort of 424,152 persons with type 2 diabetes","volume":"10","author":"Grauslund","year":"2024","journal-title":"Int J Retina Vitreous"},{"issue":"4","key":"2026070603020301000_luag108-B8","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.ophtha.2024.10.030","article-title":"Association between semaglutide and nonarteritic anterior ischemic optic neuropathy: a multinational population-based 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