The Risk of Retinal Vascular Events in Patients Using Semaglutide: A Scoping Review

Area of Science:

• Ophthalmology
• Endocrinology
• Clinical Pharmacology

Background:

• Semaglutide is a glucagon-like peptide-1 receptor agonist used for type 2 diabetes and obesity.
• Retinal vascular events (RVEs) and optic ischemic neuropathies (OINs) are potential safety concerns.
• Existing clinical trial data on semaglutide and RVEs requires comprehensive review.

Purpose of the Study:

• To conduct a scoping review of clinical trials assessing the association between semaglutide and RVEs.
• To identify any potential safety signals related to semaglutide use and ophthalmic vascular events.
• To evaluate the capacity of the review methodology to detect rare adverse events.

Main Methods:

• Scoping review adhering to PRISMA-ScR guidelines.
• Searches conducted across PubMed, Embase, ClinicalTrials.gov, and Google Scholar.
• Inclusion of randomized clinical trials investigating semaglutide in patients with type 2 diabetes or obesity, with RVEs and OINs as outcomes.

Main Results:

• Thirteen randomized clinical trials (17,478 semaglutide vs. 17,334 placebo) were included.
• A higher number of RVEs were reported in semaglutide arms (15) compared to placebo arms (4).
• Incidence rates for RVEs and OINs were numerically higher in semaglutide groups across various trial designs.

Conclusions:

• Retinal vascular events, particularly retinal arterial occlusions, showed a higher reporting pattern with semaglutide.
• Optic ischemic neuropathies were also more frequently reported in semaglutide-treated patients.
• Findings indicate a need for further investigation via large-scale registry studies to confirm safety signals.