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Another paper this week on semaglutides and NAION

  • 1.  Another paper this week on semaglutides and NAION



  • 2.  RE: Another paper this week on semaglutides and NAION

    Posted 08-21-2025 11:19
    The hits just keep on coming!





  • 3.  RE: Another paper this week on semaglutides and NAION

    Posted 08-21-2025 12:08
    Is no one else amazed by the doubling of risk of "other optic nerve disorders"?  They don't say, but likely it would have been a melange of optic neuritis, ONH drusen, etc.  We only know that the ICD-10 code was H47.0 and most were H47.3 (other).  How could semaglutides produce these?  Or were these coding errors for NAION (especially those marked optic atrophy)?  But that was only a small fraction of the "others". This points out the problem with such a study.  A chain is as strong as its weakest link.

    --Alfredo






  • 4.  RE: Another paper this week on semaglutides and NAION

    Posted 08-21-2025 11:25
    Thanks for sharing!
    This paper shows slightly increased risk using large claims data.

    To better understand how these patients present, I still think there should be value in having a registry (eg . Are we seeing more rapid sequential or bilateral cases?) Some members have expressed interest. Where are we with this? And who would be best equipped to initiate this or give reasons not to do a registry?

    Sangeeta

    Sangeeta Khanna MD
    University of Michigan






  • 5.  RE: Another paper this week on semaglutides and NAION

    Posted 08-21-2025 11:30
    I would vote that we have Nordic head this up, and completely agree nanos should be leading the word on the street on this topic. Does Nordic have the ability to keep a nanos specific database? Should we instead create something for the IRIS registry at AAO? Happy to work on this with folks.
    Kim




  • 6.  RE: Another paper this week on semaglutides and NAION

    Posted 08-21-2025 11:57
    There are a number of issues when trying to start these databases, including cost of maintaining and vetting. In addition, when physicians are busy, they may not elect to take the time to put all the information into the database, so you have some patients who are not added and some that are added incorrectly or with limited data. It is a much bigger undertaking than it might appear. 





  • 7.  RE: Another paper this week on semaglutides and NAION

    Posted 08-21-2025 11:41
    It is tough with these big data studies to determine if there is a true small risk because they are dependent on diagnosis codes, etc.  There are attempts to correct for bias with propensity scoring, but it is still difficult.  There is likely a small association, but it is yet to be determined if this is causative or association.  I agree that a database of patients where NAION can be confirmed by manual review of charts would be more powerful.  Wash U, Mayo, and Oklahoma recently published on bilateral simultaneous NAIONs and we are now looking to see how many were on GLP1RAs.  I agree that a NANOS-wide registry would be helpful.  We looked into this as part of the Outcomes committee, but there were large issues with DUAs and IRBs that are creating barriers in sharing data.  We discussed creating a registry with purely deidentified information, but even then most institutions required DUAs to share data.  We will discuss this further as a group.  We will also discuss this with NORDIC.
    best,
    John





  • 8.  RE: Another paper this week on semaglutides and NAION

    Posted 08-21-2025 12:08

    Lee et al had reported "The annual incidence of NAION was 82 per 100,000." in the year 2011 in ophthalmology . I wonder what is it now. Ozempic is a phenomenon in the USA(12% of US population has used Ozempic till 2024). I wonder if it's increased the incidence of NAION…? 

    If it's difficult to prove it in one way then maybe we should try and look at it the other way… just a thought.

     I am sure great minds are working on it ,some looking at the greater overall systemic benefit of the drug that maybe cancels out the partial loss of vision in one or both the eyes



    ------------------------------
    Shikha
    ------------------------------



  • 9.  RE: Another paper this week on semaglutides and NAION

    Posted 08-21-2025 17:29

    There was recently a meta-analysis that we considered for the JNO Lit Commentary but decided to cool off on the topic for a while.

     

     

    Acta Ophthalmol . 2025 Sep;103(6):615-621.

     doi: 10.1111/aos.17473. Epub 2025 Mar 8.

    Semaglutide and non-arteritic anterior ischaemic optic neuropathy: Review and interpretation of reported association

    Abdullah Amini 1 2Steffen Hamann 1 2Michael Larsen 1 2

     






  • 10.  RE: Another paper this week on semaglutides and NAION

    Posted 09-04-2025 14:41

    Happy Friday!

    I will be traveling most of the day tomorrow to speak at a Neurology conference in Puerto Rico and know that my emails likely won't send from my destination so, despite the topic for this week, I'm early!

    Tomorrow is National Be Late to Something Day, giving everyone permission to be late to one thing on the schedule. The Procrastinators Club of America created the day shortly after their founding in 1956 to encourage people to slow down, smell the roses, and relieve the stress of having to always be on time. However, it is not about being irresponsible or causing inconvenience to others. The concept of being on time is a big one in our home. Scott says that "early is on time, on time is late, and late is dead". For some circumstances, such as a job interview, business meeting or a professional appointment, that's true. But a dinner party is a different story, spoken from the one who prepares them.

    Being on time or late is often cultural. In the U.S., it may also be regional. I grew up in south Florida and being "fashionably late" for a social event (meaning 5-15 minutes, possibly more, depending on the event and the venue) was the norm. I attended a party recently where most people didn't arrive until an hour or more after the start time. Scott grew up in the northeast where people are apparently more punctual. In some countries, the trains are always on time and being late is a sign of disrespect. Arriving on time is considered rude in countries where people are more relaxed about timing. The concept of late arrival is often named for the group that exhibits it: "Thai time" (at least an hour late), Jewish Standard Time (up to about 15 minutes late), Mexican time (up to 30 minutes late), etc.

    The term "fashionably late" may have originated with celebrities and other high-status people who arrived late to make a grand entrance and attract attention. Narcissists, in other words.

    One theory about tardiness is that some cultures are characterized by clock time, so-called "monochronic" cultures where everything is governed by the clock. These cultures emphasize the wise use of time and value business and achievement more than social considerations. In contrast, event time, which is "polychronic", depends on how social events to shape the beginning, duration and ending of activities. An example is running into a friend on the street and deciding to go have coffee together. Event time often involves switching between activities and combining social and work activities. Although a clock is involved, its use is more elastic.

    Status can also play a role in timeliness. Remember the rule about how long the class needed to wait for a graduate student vs an assistant, associate or full professor to show up? The higher the status, the longer the wait and the more acceptable the tardiness. 

    Interestingly, there are websites delineating valid or acceptable excuses for being late to work or an interview. This can happen to any of us on occasion. However, some people are habitual offenders. At least in the U.S., timeliness is a manifestation of professionalism and being consistently late sends the message that the person is unreliable. This can affect one's reputation and influence promotion and compensation. 

    One of the most common reasons for habitual tardiness was termed The Planning Fallacy by Professors Daniel Kahneman and Amos Tversky (winners of the Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel in 1979 and the Nobel Prize in Economic Sciences in 2002). Also known as "optimism bias", it is the tendency to underestimate the amount of time needed to complete a future task, due in part to the reliance on overly optimistic performance scenarios. Chronically late people tend to consistently assume that their own tasks will get done sooner and more easily than they really do. Conversely, a third-party observer will generally estimate that the tardy person's tasks will take longer. Distractions along the way, such as small tasks involved in getting out of the house or arriving at a meeting (even on video; something always goes wrong with the computer. I know this but am often in denial.) tend to add up, thus making people late.

    Back to the dinner party. I try to time my preparations (cleaning, cooking, setting up, plating, getting dressed, etc.) so that I am ready just a little before the time that I set for guests to arrive. When people show up early (which many tend to do in Dallas), it's upsetting! Ten minutes late is perfect. But for an appointment in my office, early is on time.

    Tomorrow (Friday) you have license to be late for something. Just a word of caution to make sure it won't get you into trouble.

    Have a great weekend!

    Deb

    https://www.youtube.com/watch?v=hqwLrJ6QWho

     






  • 11.  RE: Another paper this week on semaglutides and NAION

    Posted 09-16-2025 09:27

    Hi!

    I was just on ClinicalTrials.gov and did not see any trials in the US that were actively recruiting for LHON. If anyone is aware of a trial, please let me know.

    Thanks!

    Deb