Non-Arteritic Anterior Ischaemic Optic Neuropathy Associated with Semaglutide use.

PRESENTATION: Non-arteritic ischaemic optic neuropathy (NAION) is a common cause of acute, painless monocular visual disturbance in older adults. This case discusses a woman in her 70s with vascular risk factors who presented with a three-day history of progressive left sided visual disturbance. Examination demonstrated a left relative afferent pupillary defect and inferior quadrantopia.

DIAGNOSIS: Haematological investigations and neuroimaging were unremarkable. Formal ophthalmological assessment demonstrated superior optic disc swelling with an inferior visual field defect, consistent with NAION.

TREATMENT: The patient had been taking semaglutide, as prescribed, for the six months prior to presentation. This was identified as a potential contributory agent and was discontinued. Visual acuity partially improved following cessation of semaglutide.

DISCUSSION: This case seeks to highlight a possible association between semaglutide use and NAION. Although causality remains unproven, it underscores the importance of pharmacovigilance when manging patients presenting with ophthalmological symptoms.