Bracha Peter, Johnson William, Chu Sabrina, Davison James
Wolfe Eye Clinic, 6200 Westown Parkway, West Des Moines, Iowa, USA.
Des Moines University College of Osteopathic Medicine, 3200 Grand Ave, Des Moines, IA, USA.
Am J Ophthalmol Case Rep. 2024 Jul 26;36:102121. doi: 10.1016/j.ajoc.2024.102121. eCollection 2024 Dec.
Semaglutide is a glucagon-like peptide-1 receptor agonist that treats type 2 diabetes mellitus and can be used as an adjunct for weight loss when combined with exercise and diet. Here we report a case of a bilateral, incongruent central visual scotoma under scotopic conditions in a board-certified ophthalmologist associated with semaglutide use that resolved quickly following medication discontinuation.
A 72-year-old male ophthalmologist (JAD) started 3.0 mg daily oral semaglutide (Rybelsus) to help with weight loss and seventeen days after treatment initiation developed a small, round central scotoma in his right eye that enlarged over several days. After two days a similar but smaller scotoma developed in his left eye. These symptoms were present only under scotopic conditions and were not visible in daylight or artificially lit conditions. When symptoms developed in the left eye, the medication was discontinued, and all symptoms completely resolved two days later. A subsequent clinical evaluation revealed no abnormalities on macular optical coherence tomography, fundus photography, fundus autofluorescence or Humphrey visual field.
This case of a bilateral central scotoma under scotopic conditions that resolved after medication discontinuation expands the knowledge of potential side effects from this increasingly popular diabetic and weight loss medication.
司美格鲁肽是一种胰高血糖素样肽-1受体激动剂，用于治疗2型糖尿病，与运动和饮食相结合时可作为减肥辅助药物。在此，我们报告一例在一名获得认证的眼科医生中，使用司美格鲁肽后在暗视条件下出现双侧、不对称的中心性视野暗点，停药后迅速缓解的病例。
一名72岁男性眼科医生（JAD）开始每日口服3.0毫克司美格鲁肽（Rybelsus）以帮助减肥，治疗开始17天后，其右眼出现一个小的圆形中心暗点，并在数天内扩大。两天后，其左眼出现类似但较小的暗点。这些症状仅在暗视条件下出现，在日光或人工照明条件下不可见。当左眼出现症状时，停用了该药物，两天后所有症状完全缓解。随后的临床评估显示，黄斑光学相干断层扫描、眼底摄影、眼底自发荧光或 Humphrey 视野检查均无异常。
该例在暗视条件下出现双侧中心暗点且停药后缓解的病例，扩展了对这种日益流行的糖尿病和减肥药物潜在副作用的认识。
