Clinical Report: NRTI Use and Risk of Developing POAG

Overview

A retrospective cohort study found a significant association between nucleoside and nucleotide reverse transcriptase inhibitors (NRTIs) and an increased risk of primary open-angle glaucoma (POAG). Among 718 NRTI users, 4.32% developed POAG compared to 2% of matched nonusers.

Background

Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness worldwide, making its risk factors critical for prevention and management. NRTIs are widely used in the treatment of HIV and hepatitis B, and understanding their potential ocular side effects is essential for patient care. This study adds to the growing body of literature examining the safety profile of antiretroviral therapies.

Data Highlights

Key Findings

• 4.32% of NRTI users developed POAG compared to 2% of nonusers.
• Unadjusted odds ratio for POAG in NRTI users was 2.21 (P<.001).
• After adjusting for key covariates, the odds ratio remained significant at 1.84 (P=.004).
• No significant association was found between NRTI use and cataracts or angle-closure glaucoma.
• Self-reported eye care utilization was similar between NRTI users and nonusers.
• Further investigation is warranted to explore the role of HIV infection in the observed association.

Clinical Implications

Clinicians should be aware of the potential increased risk of POAG in patients receiving NRTIs and consider regular eye examinations for these patients. The findings suggest a need for further research into the mechanisms linking NRTI use and glaucoma risk.

Conclusion

This study highlights a significant association between NRTI use and the risk of developing POAG, warranting further investigation into the underlying mechanisms. Clinicians should remain vigilant in monitoring ocular health in patients undergoing antiretroviral therapy.

References

1. University of Pennsylvania, Ophthalmology, 2023 -- Association between Nucleoside and Nucleotide Reverse Transcriptase Inhibitor Use and Primary Open-Angle Glaucoma Risk in All of Us
2. Ophthalmology Management — Large US Study Adds to Connection between NAION Risks and GLP1 Drugs
3. Retinal Physician — GLP-1 Receptor Agonists Linked to Increased nAMD Risk
4. Glaucoma Physician — The Impact of GLP-1 Receptor Agonists on Ocular Disease
5. retinal physician — GLP-1 Receptor Agonists Linked to Increased nAMD Risk
6. Advancing glaucoma care: What's new in the 6th edition of the European Glaucoma Society guidelines
7. Large US Study Adds to Connection between NAION Risks and GLP1 Drugs
8. GLP-1 Receptor Agonists Linked to Increased nAMD Risk
9. The Impact of GLP-1 Receptor Agonists on Ocular Disease
10. Association between Nucleoside and Nucleotide Reverse Transcriptase Inhibitor Use and Primary Open-Angle Glaucoma Risk in All of Us - PubMed