Ocular Adverse Events With Semaglutide
Bibliographic record
Abstract
Importance: Semaglutide is a widely used treatment for diabetes and obesity, offering considerable cardiovascular benefit. However, its association with ocular adverse events remains uncertain. Objective: To assess the incidence of eye disorders, diabetic retinopathy, and nonarteritic anterior ischemic optic neuropathy (NAION) in adults treated with semaglutide. Data Sources: A comprehensive electronic search of PubMed, Embase, and the Cochrane Central Register of Controlled Trials was conducted on April 10, 2025, without date restrictions. Study Selection: Investigators independently screened records to identify randomized clinical trials comparing semaglutide with either an active comparator or placebo in adults, assessing ocular adverse events. Data Extraction and Synthesis: Descriptive synthesis of the included studies was performed. The random-effects model using the inverse variance method was used to summarize the odds ratio (OR) for eye disorders and diabetic retinopathy. Peto OR with a fixed-effects model was applied for NAION. Risk of bias was assessed with the RoB 2.0 tool and quality of evidence with GRADE. Trial sequential analysis (TSA) was performed to determine whether the available data were sufficient for definitive conclusions. Main Outcomes and Measures: The primary outcomes included the number of patients experiencing an ocular adverse event, diabetic retinopathy, or NAION. Subgroup analyses were conducted based on follow-up duration, comparator type, and primary baseline condition. Results: A total of 78 trials with 73 640 participants were included. Semaglutide did not increase or reduce the risk of eye disorders (OR, 1.01; 95% CI, 0.91-1.12) or diabetic retinopathy (OR, 1.04; 95% CI, 0.92-1.17). Treatment with semaglutide was associated with a significant odds of NAION (OR, 3.92; 95% CI, 1.02-15.02). Overall risk of bias was low. TSA provided evidence that the sample size was sufficient to avoid missing alternative results for diabetic retinopathy but not for NAION. Conclusions and Relevance: These findings suggest that semaglutide was not associated with an increased risk of eye disorders or diabetic retinopathy. Despite the fact that an association between semaglutide treatment and NAION was found, current evidence remains insufficient to establish definitive conclusions regarding its association with NAION. Further studies with larger sample sizes and adequate evaluation of NAION are warranted to clarify this potential risk.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.021 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.006 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".