NANOSNET

Original Message:
Sent: 7/13/2025 10:51:00 AM
From: Larry Frohman
Subject: Semaglutides

I got asked a question- I doubt there is an answer based upon data yet, but I will ask anyway

Has anyone seen any data on NAION in patients who have stoppped semaglutides?

In other words, is there an increased risk based upon cumulative exposure even after stopping the drug?  And if so, for hiow long does one relain at risk after the d/c?  A month, a year,...

Such a risk, outside of a few days, does not make any sense to me.

Thanks in advance for your thoughts.

Original Message:
Sent: 7/13/2025 10:51:00 AM
From: Larry Frohman
Subject: Semaglutides

I got asked a question- I doubt there is an answer based upon data yet, but I will ask anyway

Has anyone seen any data on NAION in patients who have stoppped semaglutides?

In other words, is there an increased risk based upon cumulative exposure even after stopping the drug?  And if so, for hiow long does one relain at risk after the d/c?  A month, a year,...

Such a risk, outside of a few days, does not make any sense to me.

Thanks in advance for your thoughts.

It might be hard to know - unless someone specifically asks the question about previous use, we could easily miss it, as we typically ask about current meds. 

But maybe it's time for us to add it to the our: PDE-5s, high altitude, use of GLP1/new weight loss drugs.

Deb

Original Message:
Sent: 07-13-2025 15:05
From: Bradley Katz
Subject: Semaglutides

I'm not aware of any reports of NAION after stopping a GLP1-R drug 

Brad Katz

Original Message:
Sent: 7/13/2025 10:51:00 AM
From: Larry Frohman
Subject: Semaglutides

I got asked a question- I doubt there is an answer based upon data yet, but I will ask anyway

Has anyone seen any data on NAION in patients who have stoppped semaglutides?

In other words, is there an increased risk based upon cumulative exposure even after stopping the drug?  And if so, for hiow long does one relain at risk after the d/c?  A month, a year,...

Such a risk, outside of a few days, does not make any sense to me.

Thanks in advance for your thoughts.

I’ll take this opportunity to make a plug for the NANOS 2026 annual meeting in Boston which will include a 2 hour symposium on NAION risk factors, including discussion on GLP1 drugs, other iatrogenic contributors, systemic diseases and anatomical. An epidemiologist will discuss how to interpret the studies and we’ll have a rousing discussion on what is clinically actionable.

It will be on March 24 (Tuesday), which is the last day of the meeting, so don’t leave early or you’ll miss out!

Heather
(President elect and NANOS 2026 program chair)

Sent from my iPhone


Original Message:
Sent: 7/13/2025 3:10:00 PM
From: Deborah Friedman
Subject: RE: Semaglutides

It might be hard to know - unless someone specifically asks the question about previous use, we could easily miss it, as we typically ask about current meds. 

But maybe it's time for us to add it to the our: PDE-5s, high altitude, use of GLP1/new weight loss drugs.

Deb

Original Message:
Sent: 07-13-2025 15:05
From: Bradley Katz
Subject: Semaglutides

I'm not aware of any reports of NAION after stopping a GLP1-R drug 

Brad Katz

Original Message:
Sent: 7/13/2025 10:51:00 AM
From: Larry Frohman
Subject: Semaglutides

I got asked a question- I doubt there is an answer based upon data yet, but I will ask anyway

Has anyone seen any data on NAION in patients who have stoppped semaglutides?

In other words, is there an increased risk based upon cumulative exposure even after stopping the drug?  And if so, for hiow long does one relain at risk after the d/c?  A month, a year,...

Such a risk, outside of a few days, does not make any sense to me.

Thanks in advance for your thoughts.

Original Message:
Sent: 7/13/2025 10:51:00 AM
From: Larry Frohman
Subject: Semaglutides

I got asked a question- I doubt there is an answer based upon data yet, but I will ask anyway

Has anyone seen any data on NAION in patients who have stoppped semaglutides?

In other words, is there an increased risk based upon cumulative exposure even after stopping the drug?  And if so, for hiow long does one relain at risk after the d/c?  A month, a year,...

Such a risk, outside of a few days, does not make any sense to me.

Thanks in advance for your thoughts.

Original Message:
Sent: 7/13/2025 5:49:00 PM
From: Edward Cohn
Subject: RE: Semaglutides

Dear Dr. Moss

When you want to classify/group those at risk of NAION, do think we might add a group consisting of those under extreme tension/stress (I.e. death of a loved one, job insecurity, money infirmitude or illness in/for caring of a family member, etc).

It's amazing to me how, when a careful history is taken, mental anguish predates (~ 6 mos) a number of NAION patients.

It just a thought. Sometimes we are our worst enemies and make ourselves sick.

Edward M. Cohn, MD, mba, mph

3535 W 13 Mile (506)

Royal Oak, MI 48073

Ph: 248-551-8282

http://www.umich.edu/~edcohnmd

Sent from my iPhone

Original Message:
Sent: 7/13/2025 10:51:00 AM
From: Larry Frohman
Subject: Semaglutides

I got asked a question- I doubt there is an answer based upon data yet, but I will ask anyway

Has anyone seen any data on NAION in patients who have stoppped semaglutides?

In other words, is there an increased risk based upon cumulative exposure even after stopping the drug?  And if so, for hiow long does one relain at risk after the d/c?  A month, a year,...

Such a risk, outside of a few days, does not make any sense to me.

Thanks in advance for your thoughts.

Original Message:
Sent: 7/13/2025 7:48:00 PM
From: Floyd Warren
Subject: RE: Semaglutides

Ed,

W ould be hard to know, as in Deb's posting, not something we routinely ask about.

 Also for how long before would we consider? (who of us hasn't had stress in the last 6 months) and how do establish the control group?

Floyd 

Sent from the all new AOL app for iOS

Original Message:
Sent: 7/13/2025 5:49:00 PM
From: Edward Cohn
Subject: RE: Semaglutides

Dear Dr. Moss

When you want to classify/group those at risk of NAION, do think we might add a group consisting of those under extreme tension/stress (I.e. death of a loved one, job insecurity, money infirmitude or illness in/for caring of a family member, etc).

It's amazing to me how, when a careful history is taken, mental anguish predates (~ 6 mos) a number of NAION patients.

It just a thought. Sometimes we are our worst enemies and make ourselves sick.

Edward M. Cohn, MD, mba, mph

3535 W 13 Mile (506)

Royal Oak, MI 48073

Ph: 248-551-8282

http://www.umich.edu/~edcohnmd

Sent from my iPhone

Original Message:
Sent: 7/13/2025 10:51:00 AM
From: Larry Frohman
Subject: Semaglutides

I got asked a question- I doubt there is an answer based upon data yet, but I will ask anyway

Has anyone seen any data on NAION in patients who have stoppped semaglutides?

In other words, is there an increased risk based upon cumulative exposure even after stopping the drug?  And if so, for hiow long does one relain at risk after the d/c?  A month, a year,...

Such a risk, outside of a few days, does not make any sense to me.

Thanks in advance for your thoughts.

Original Message:
Sent: 7/14/2025 12:05:00 AM
From: Matthew Kay
Subject: RE: Semaglutides

I have definitely had patients with NAION who had previously been on semaglutide or related agents and developed their visual loss at various points Following cessation of therapy. I have presumed the NAION is unrelated, And I am not at all yet convinced that there is a causal relationship as opposed to simply an association In the cases that have been reported over the last two years and those encountered in my practice.

Matt

Sent via the Samsung Galaxy S21 5G, an AT&T 5G smartphone

Original Message:
Sent: 7/13/2025 7:48:00 PM
From: Floyd Warren
Subject: RE: Semaglutides

Ed,

W ould be hard to know, as in Deb's posting, not something we routinely ask about.

 Also for how long before would we consider? (who of us hasn't had stress in the last 6 months) and how do establish the control group?

Floyd 

Sent from the all new AOL app for iOS

Original Message:
Sent: 7/13/2025 5:49:00 PM
From: Edward Cohn
Subject: RE: Semaglutides

Dear Dr. Moss

When you want to classify/group those at risk of NAION, do think we might add a group consisting of those under extreme tension/stress (I.e. death of a loved one, job insecurity, money infirmitude or illness in/for caring of a family member, etc).

It's amazing to me how, when a careful history is taken, mental anguish predates (~ 6 mos) a number of NAION patients.

It just a thought. Sometimes we are our worst enemies and make ourselves sick.

Edward M. Cohn, MD, mba, mph

3535 W 13 Mile (506)

Royal Oak, MI 48073

Ph: 248-551-8282

http://www.umich.edu/~edcohnmd

Sent from my iPhone

Original Message:
Sent: 7/13/2025 10:51:00 AM
From: Larry Frohman
Subject: Semaglutides

I got asked a question- I doubt there is an answer based upon data yet, but I will ask anyway

Has anyone seen any data on NAION in patients who have stoppped semaglutides?

In other words, is there an increased risk based upon cumulative exposure even after stopping the drug?  And if so, for hiow long does one relain at risk after the d/c?  A month, a year,...

Such a risk, outside of a few days, does not make any sense to me.

Thanks in advance for your thoughts.

Original Message:
Sent: 7/14/2025 5:34:00 AM
From: Scott Forman
Subject: RE: Semaglutides

There is a difference between everyday stress, which helps mitochondria genesis and significant stressors like the loss of a loved one, an acute life threatening event, etc. I think that is what Dr. Cohn refers to and I do that myself as part of my routine history for any new patient. 

+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=

Scott Forman, MD

Senior Fellow North American Neuro-ophthalmology Society

Adult and Pediatric Neuro-ophthalmology

Comprehensive Ophthalmology

Functional Medicine

Original Message:
Sent: 7/14/2025 12:05:00 AM
From: Matthew Kay
Subject: RE: Semaglutides

I have definitely had patients with NAION who had previously been on semaglutide or related agents and developed their visual loss at various points Following cessation of therapy. I have presumed the NAION is unrelated, And I am not at all yet convinced that there is a causal relationship as opposed to simply an association In the cases that have been reported over the last two years and those encountered in my practice.

Matt

Sent via the Samsung Galaxy S21 5G, an AT&T 5G smartphone

Original Message:
Sent: 7/13/2025 7:48:00 PM
From: Floyd Warren
Subject: RE: Semaglutides

Ed,

W ould be hard to know, as in Deb's posting, not something we routinely ask about.

 Also for how long before would we consider? (who of us hasn't had stress in the last 6 months) and how do establish the control group?

Floyd 

Sent from the all new AOL app for iOS

Original Message:
Sent: 7/13/2025 5:49:00 PM
From: Edward Cohn
Subject: RE: Semaglutides

Dear Dr. Moss

When you want to classify/group those at risk of NAION, do think we might add a group consisting of those under extreme tension/stress (I.e. death of a loved one, job insecurity, money infirmitude or illness in/for caring of a family member, etc).

It's amazing to me how, when a careful history is taken, mental anguish predates (~ 6 mos) a number of NAION patients.

It just a thought. Sometimes we are our worst enemies and make ourselves sick.

Edward M. Cohn, MD, mba, mph

3535 W 13 Mile (506)

Royal Oak, MI 48073

Ph: 248-551-8282

http://www.umich.edu/~edcohnmd

Sent from my iPhone

Original Message:
Sent: 7/13/2025 10:51:00 AM
From: Larry Frohman
Subject: Semaglutides

I got asked a question- I doubt there is an answer based upon data yet, but I will ask anyway

Has anyone seen any data on NAION in patients who have stoppped semaglutides?

In other words, is there an increased risk based upon cumulative exposure even after stopping the drug?  And if so, for hiow long does one relain at risk after the d/c?  A month, a year,...

Such a risk, outside of a few days, does not make any sense to me.

Thanks in advance for your thoughts.