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Optic Nerve Health

Master reference list (verified Nov 10, 2026, America/New_York)

Reviewed by James Deom, OD, MPH, FAAO, Chief of Eye Care Services. Last reviewed: November 10, 2026.

Every entry below was opened or confirmed against its publisher, PubMed, or a regulator page on Nov 10, 2026. Tags: [V] verified from the source page or abstract · [V-abs] verified from the abstract only (full text not opened) · [K] well-known citation, not re-fetched this session. Entries marked [V-10pm] were added or upgraded later the same day (afternoon pass) for the study-comparison page.

Regulators and professional societies

  • [V] FDA. FDA Requires Safety Labeling Changes for GLP-1 RAs Due to Potential Increased Risk of Rare But Serious Eye Condition. Drug Safety Communication, Nov 9, 2026. https://www.fda.gov/drugs/drug-safety-communications/fda-requires-safety-labeling-changes-glucagon-peptide-1-receptor-agonists-glp-1-ras-due-potential
  • [V] EMA PRAC. PRAC concludes eye condition NAION is a very rare side effect of semaglutide medicines Ozempic, Rybelsus and Wegovy. Jun 6, 2025 (revised Jun 13, 2025). https://www.ema.europa.eu/en/news/prac-concludes-eye-condition-naion-very-rare-side-effect-semaglutide-medicines-ozempic-rybelsus-wegovy
  • [V] WHO. The use of semaglutide medicines and risk of NAION. Jun 27, 2025. https://www.who.int/news/item/27-06-2025-27-06-2025-semaglutide-medicines-naion/
  • [V] AAO & NANOS. GLP-1 Receptor Agonists and the Risk of NAION: A Consensus Statement by NANOS and the American Academy of Ophthalmology (published May 2026 per AAO). https://www.aao.org/education/clinical-statement/glucagon-like-peptide-1-receptor-agonists-risk-of-
  • [V] AAO & NANOS. What the Data Say About GLP-1 Drugs and Vision Loss. News release, Sep 22, 2026. https://www.aao.org/newsroom/news-releases/detail/what-data-say-about-glp-1-drugs-vision-loss (mirror: https://www.newswise.com/articles/what-the-data-say-about-glp-1-drugs-and-vision-loss)
  • [V] AOA. Clinical Report: GLP-1 receptor agonists (Evidence-Based Optometry), June 2025. https://www.aoa.org/AOA/Documents/Practice%20Management/Clinical%20Guidelines/AOA%20GLP-1_EBO_clinical-report.pdf · Patient page: https://www.aoa.org/healthy-eyes/caring-for-your-eyes/glp-1-medications-and-your-vision

GLP-1 RA and NAION studies

  • [V] Hathaway JT, et al. Risk of NAION in patients prescribed semaglutide. JAMA Ophthalmol. 2024;142(8):732-739. doi:10.1001/jamaophthalmol.2024.2296. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2820255
  • [V] Grauslund J, et al. Once-weekly semaglutide doubles the five-year risk of NAION in a Danish cohort of 424,152 persons with type 2 diabetes. Int J Retina Vitreous. Dec 18, 2024. https://link.springer.com/article/10.1186/s40942-024-00620-x
  • [V] Danish–Norwegian cohort (Simonsen et al.). Use of semaglutide and risk of NAION: a Danish–Norwegian cohort study. Diabetes Obes Metab. 2025;27(6):3094-3103. https://pubmed.ncbi.nlm.nih.gov/40098249/
  • [V-abs] Cai CX, et al. (OHDSI network). Semaglutide and NAION. JAMA Ophthalmol. 2025. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2830475
  • [V-abs] Hsu AY, et al. Semaglutide and NAION Risk Among Patients With Diabetes. JAMA Ophthalmol. 2025. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2831924. HRs at 2 years 2.39 (1.37–4.18), 3 years 2.44 (1.44–4.12), and 4 years 2.05 (1.26–3.34), confirmed this turn from publisher/AAO summaries of the article.
  • [V-abs] Abbass NJ, et al. The Effect of Semaglutide and GLP-1 RAs on Risk of NAION. Am J Ophthalmol. 2025. https://www.ajo.com/article/S0002-9394(25)00094-7/fulltext. No increased risk; T2D semaglutide cumulative incidence 0.039% (1 yr), 0.057% (3 yr), 0.065% (5 yr).
  • [V-abs] Semaglutide or tirzepatide (combined exposure) in T2D: HR 1.76 (95% CI 1.01-3.07). JAMA Netw Open. 2025. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2837377
  • [V-10pm] McDonald CJ, Fung KW. GLP-1 RAs and Risk of NAION in Older Patients With Diabetes. JAMA Ophthalmol. 2025 (research letter). https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2836771. Semaglutide HR 1.39 (95% CI 1.13–1.72) vs other second-line agents, previously listed from AJMC/Medscape summaries; primary citation identified this turn. The JAMA full text itself was not successfully opened (fetch timeout); agent-specific figures for liraglutide, dulaglutide, and exenatide that appear in news coverage of the letter were not added to patient-facing copy pending the letter itself.
  • [V-10pm] Chou CC, et al. Association between Semaglutide and Nonarteritic Anterior Ischemic Optic Neuropathy: A Multinational Population-Based Study. Ophthalmology. 2024. doi:10.1016/j.ophtha.2024.10.030. https://www.aaojournal.org/article/S0161-6420(24)00685-7/fulltext. No significant association at 1, 2, or 3 years in T2D-only, obesity-only, or combined groups (abstract/publisher page).
  • [V-10pm] Lieberman RA, Korona-Bailey J, Banaag A, Furhman B, Corrado R, Koehlmoos TP. Semaglutide Decreases Risk of Non-Arteritic Anterior Ischemic Optic Neuropathy in Type 2 Diabetic Patients. Mil Med. 2026;191(5-6):e1020. doi:10.1093/milmed/usaf522. https://academic.oup.com/milmed/article/191/5-6/e1020/8320596. 1,212,775 adults; T2D adjusted OR 0.36 (0.25–0.51); overweight/obesity OR 0.10 (0.01–1.35), NS. Cited by AAO/NANOS. Present as a non-increased-risk / unexpected-direction finding, not as proof of a protective effect.
  • [V] Noh Y, et al. GLP-1 RAs and Risk of NAION in Patients With Type 2 Diabetes. Diabetes Care. 2026;49(5):763-771. https://diabetesjournals.org/care/article/49/5/763/164499/
  • [V] Ueda P, et al. GLP-1 RAs and Risk for Anterior Ischemic Optic Neuropathy: A Nationwide Cohort Study. Ann Intern Med. 2026;179(9):1232-1243. doi:10.7326/ANNALS-25-02096. https://www.acpjournals.org/doi/10.7326/ANNALS-25-02096
  • [V] Chrzanowski J, et al. Semaglutide-associated risk of NAION in patients with T2D: systematic review and meta-analysis. PLoS Med. 2026;23(5):e1005064. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005064
  • [V-abs] Dhivagaran T, et al. GLP-1 RAs and Risk of NAION: Systematic Review and Meta-Analysis. Neurology. 2026;106(10):e214864. https://www.neurology.org/doi/10.1212/WNL.0000000000214864
  • [V-abs] Lampsas S, et al. Semaglutide and risk of NAION in T2D: systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol. 2026. doi:10.1007/s00417-026-07291-4
  • [V-abs] Sun et al. Comparative Risk of NAION Among GLP-1 RAs: An Integrated Safety and Mechanistic Analysis. Diabetes Obes Metab. 2026. doi:10.1111/dom.71358. https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.71358
  • [V-abs] Semaglutide and the Risk of NAION (meta-analysis; pooled aHR 1.63, 95% CI 0.88-2.39, not significant). Ophthalmology. 2026. https://www.aaojournal.org/article/S0161-6420(26)00082-5/fulltext
  • [V-abs] Ho C, et al. 1972-LB: GLP-1 RAs and NAION, a Systematic Review and Meta-analysis. Diabetes. 2025 (ADA abstract). https://doi.org/10.2337/db25-1972-lb

NAION background and risk factors

  • [V-abs] Cestari DM, et al. Demographic, Systemic, and Ocular Factors Associated with NAION. Ophthalmology. 2016. https://pubmed.ncbi.nlm.nih.gov/27659545/
  • [V] Gabbay et al. Hypoperfusion states could increase the risk of NAION. PLoS One. 2024. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0313098
  • [V-abs] Liu B, et al. Risk Factors for NAION: A Large Scale Meta-Analysis. Front Med. 2021;8:618353. https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.618353/full
  • [V-abs] Cardiometabolic factors and risk of NAION: systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol. 2022. https://pubmed.ncbi.nlm.nih.gov/35067769/
  • [V-abs] Chen T, et al. The association between diabetes mellitus and NAION: systematic review and meta-analysis. PLoS One. 2013. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0076653
  • [V-abs] OSA and increased risk of NAION (Korean national cohort, 919 OSA vs 9,190 controls; aHR 3.80). Br J Ophthalmol. 2019;103(8):1123. https://bjo.bmj.com/content/103/8/1123
  • [V-abs] Aptel F, et al. Association of NAION with OSA syndrome (CPAP non-adherence and fellow-eye NAION, HR 5.54). JAMA Ophthalmol. 2015. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2276934
  • [V-abs] Young adults with AION: a multicenter optic disc drusen study (ODD in 51% of NAION eyes). Am J Ophthalmol. 2020. https://doi.org/10.1016/j.ajo.2020.03.052
  • [V-abs] Prevalence of optic disc drusen in young patients with NAION: a 10-year retrospective study (53.3% of eyes). J Neuroophthalmol. 2020. https://doi.org/10.1097/wno.0000000000000974
  • [V-abs] Prevalence and incidence of NAION in South Korea (prevalence 102.87 per 100,000 aged 40 and older). Br J Ophthalmol. 2018;102(7):936. https://bjo.bmj.com/content/102/7/936
  • [K] Biousse V, Newman NJ. Ischemic Optic Neuropathies. N Engl J Med. 2015;372:2428-2436.
  • [K] Biousse V, Newman NJ. Diagnosis and clinical features of common optic neuropathies. Lancet Neurol. 2016;15(13):1355-1367.

Added from the campaign comparison (verified Nov 10, 2026, later the same day)

  • [V] AAO. Glucagon-Like Peptide-1 Receptor Agonists and Diabetic Retinopathy: A Statement from the American Academy of Ophthalmology. November 2026 (Board approval October 2026). https://www.aao.org/education/clinical-statement/glucagon-like-peptide-1-receptor-agonists-diabetic
  • [V-abs] Newman NJ, et al. The fellow eye in NAION: report from the Ischemic Optic Neuropathy Decompression Trial follow-up study. Am J Ophthalmol. 2002;134:317-328. New NAION in the fellow eye in 14.7% (48/326) of patients at risk, median follow-up 5.1 years. https://www.ajo.com/article/S0002-9394(02)01639-2/abstract
  • [V] AOA comment on the FDA class labeling (Nov 9, 2026), as quoted in Optometry Times the same day (official AOA statement URL not opened). https://www.optometrytimes.com/view/fda-now-requiring-naion-warning-across-glp-1-receptor-agonist-class

Note. Verification tags in this list ([V], [V-abs], [K], [V-10pm]) describe how each citation was checked on November 10, 2026, and are included for transparency.