NRTI Use Linked to Risk for Primary Open-Angle Glaucoma

TUESDAY, July 8, 2025 (HealthDay News) — Use of nucleoside and nucleotide reverse transcriptase inhibitors (NRTIs) is associated with an increased risk for primary open-angle glaucoma (POAG), according to a study published online June 20 in Ophthalmology.

Kenneth Pham, from the University of Pennsylvania in Philadelphia, and colleagues conducted a retrospective cohort study involving 305,441 adults aged 40 years or older with linked electronic health record data from the National Institutes of Health All of Us dataset to assess the association of NRTI use with POAG. A cohort of 1:10 NRTI users to nonusers was created using a propensity score-matching design; 718 individuals with NRTI use were identified and matched with 7,180 nonusers.

The researchers found that the rate of POAG was 4.32 percent in NRTI users and 2.00 percent in the propensity score-matched control group. POAG risk was increased in association with NRTI use (odds ratio, 2.21). NRTI use remained significantly associated with an increased risk for developing POAG after adjustment for residual imbalance of family history of POAG, HIV diagnosis, and hepatitis B diagnosis (odds ratio, 1.84). NRTIs remained significantly associated with POAG risk after matching and adjusting for self-reported eye doctor visits (odds ratio, 2.30).

“A possibility that could explain the association between NRTI use and POAG risk is that increased medical surveillance associated with NRTI use could allow greater opportunity for POAG diagnosis, though we have performed multiple analyses to detect such a mechanism,” the authors write. “Moreover, analyses for cataracts and angle-closure glaucoma did not reveal an association between NRTI use and those other eye conditions. Together, these results do not find evidence that higher POAG rates observed among NRTI users can merely be attributed to more examination of the eyes.”

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