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  • 1.  GLP-1 meds and second episode of AION in eye

    Posted 6 days ago

    Good afternoon,

     

    I saw a patient this morning who has had bilateral NAION years ago with inferior altitudinal VF defect and superior disc pallor.  She was recently put on GLP-1 for obesity. 

     

    Question:  Has anyone seen a second attack of AION in an eye with patient on GLP-1?  I have not seen a report of this.  I am sending internist a note about possible risk but really am not sure if the risk would be different than someone who has not already had AION.

     

    Thanks for any insight you can provide.

     

    ELB

     

    Eric L. Berman, MD

    Dr. William A. and Sandra F. Johnson Endowed Chair in Neuro-Ophthalmology

    Director, Neuro-Ophthalmology Service

    Storm Eye Institute

    Medical University of South Carolina

     

     



  • 2.  RE: GLP-1 meds and second episode of AION in eye

    Posted 6 days ago
    I have seen a lady in her 60s with an episode of presumed bilateral NAION a couple years ago (negative MR orbits, extensive lab work, CSF) who  then had recently had an episode of painless monocular vision loss associated with disc edema documented by an ophthalmologist. By the time I had seen her, the disc edema had resolved, but her acuity and field had worsened compared to prior exams. She had just started a GLP-1 a few months prior. Her work-up was negative and working diagnosis was recurrent NAION in setting of GLP-1, although I had never made the presumptive diagnosis of recurrent NAION prior to that case. 

    Just an anecdote.

    Parker Bohm, M.D.



    Original Message


  • 3.  RE: GLP-1 meds and second episode of AION in eye

    Posted 6 days ago
    Hey Parker, 

    I'm curious what the RNFLs were reading prior to the supposed recurrent episode? If the prior episodes were pretty mild, I usually am more cautious about considering GLP1s, but if the values are already in the 60s-low 80s, I usually might consider the potential benefits for diabetes/obesity probably greater than the potential risks.

    Best
    Nathan



    Original Message


  • 4.  RE: GLP-1 meds and second episode of AION in eye

    Posted 6 days ago
    That's an interesting point, Nathan! I no longer have access to those OCTs, so I am not sure about where the RNFLs landed after the initial simultaneous NAION, but I think they were pretty thinned out. Either way, not enough data to draw any conclusions, but just something to keep in mind in case more people are seeing this clinical situation.

    PB



    Original Message


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