Cohort studycited by the Tayebat archiveabstract only checked★ key study A-ODD-16 in-depth review
Semaglutide and optic nerve stroke
Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide.
Overview
Hathaway JT et al.. JAMA Ophthalmol 2024 · PMID 38958939 · DOI 10.1001/jamaophthalmol.2024.2296
In an eye-clinic registry, semaglutide users had about 4 times more NAION, but numbers were small.
Does the study support the specific claim? Partly · Methodological quality: low
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Semaglutide and NAION risk
- How was the study done?
Retrospective matched cohort from a neuro-ophthalmology registry
- How many people, animals or samples were studied?
16,827 screened; 710 T2D, 979 overweight/obese; Patients evaluated by neuro-ophthalmologists at one academic institution
- What was actually found?
HR 4.28 (T2D).
- How large was the observed effect?
HR 4.28 (1.62-11.29)
- What do the results mean in everyday life?
Possible rare eye risk.
- What are the study's limitations?
Referral population (selection bias); Few events; Single centre
- What does it say about Elawady's specific claim?
Supports C-ODD-10.
- Do the results apply to Germany and Europe?
US data.
- What can explicitly not be concluded from this study?
Causation or population incidence.
Scientific in-depth review
1. Full reference
- Authors
- Hathaway JT, Shah MP, Hathaway DB, Zekavat SM, Krasniqi D, Gittinger JW, Cestari D, Mallery R, Abbasi B, Bouffard M, Chwalisz BK, Estrela T, Rizzo JF
- Journal
- JAMA Ophthalmol
- Year
- 2024
- Identifier
- PMID 38958939 DOI 10.1001/jamaophthalmol.2024.2296 · PMC11223051
- Verification
- verified – PubMed E-utilities efetch, 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
Semaglutide and NAION risk
3. Study design and population
- Study design
- Cohort study – Retrospective matched cohort from a neuro-ophthalmology registry
- Population
Patients evaluated by neuro-ophthalmologists at one academic institution
- Country
USA
- Period
2017-2023
- Sample size
16,827 screened; 710 T2D, 979 overweight/obese
- Inclusion and exclusion criteria
As described in the abstract; details not available in abstract.
4. Methods and endpoints
- Exposure / intervention
Semaglutide
- Comparator
Non-GLP-1 RA medications (propensity-matched)
- Endpoints
NAION
- Statistical methods
Kaplan-Meier, Cox
5. Actual results
- Results
T2D: 17 vs 6 events; 36-month incidence 8.9% vs 1.8%; HR 4.28 (1.62-11.29). Obesity: 20 vs 3; 6.7% vs 0.8%; HR 7.64 (2.21-26.36).
- Absolute risks
not reported
- Authors' conclusion
Suggests association between semaglutide and NAION; causality requires future study.
6. Strengths
- Matched design
7. Weaknesses
- Referral population (selection bias)
- Few events
- Single centre
8. Risk of bias
- Orienting tool
- ROBINS-E
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- high
- Rationale
Selection bias inherent to referral registry.
9. Assessment of the statistical interpretation
Very wide CIs; implausibly high incidences.
10. Relevance to the specific claim
Supports C-ODD-10.
11. Independent contrary findings
12. Transferability to Germany and Europe
US data.
13. Overall methodological judgement
Initial signal; later evidence mixed.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | low |
| Risk of bias | high |
| Precision of results | low |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | inconsistent |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | essentially correct but incomplete |
14. Open questions
None beyond those stated.
15. Linked fact checks
- Every major class of glucose-lowering drug (metformin, sulfonylureas, thiazolidinediones, DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 agonists) carries a documented signal of serious harm in the peer-reviewed literature. – Studies supporting the claim
- Semaglutide (Ozempic) is associated with a markedly higher risk of non-arteritic anterior ischaemic optic neuropathy (NAION), which can cause blindness (HR 4.28 in diabetes). – Studies supporting the claim
Use by the Tayebat archive
Note: according to the archive, the studies were compiled by the archive operators. Whether Dr. Elawady himself cited this study is not established.
- What the archive says about the study
Mass Eye and Ear cohort: semaglutide associated with markedly higher risk of NAION in both diabetic (HR 4.28) and obese populations.
- A. What was actually studied?
Semaglutide and NAION risk
- B. What did the authors find?
HR 4.28 (T2D).
- C. What conclusions do the authors themselves draw?
Suggests association between semaglutide and NAION; causality requires future study.
- D. What does the archive derive from it?
Used as evidence of GLP-1 harm.
- E. Is this derivation scientifically justified?
Numbers correct; the referral-registry setting and later conflicting meta-analyses are not mentioned.
- Adequacy of the interpretation (by the archive)
- essentially correct but incomplete