Objective:
To investigate the association between nucleoside and nucleotide reverse transcriptase inhibitors (NRTIs) and the risk of primary open-angle glaucoma (POAG).
Key Findings:
- 4.32% of NRTI users were diagnosed with POAG compared to 2% of matched nonusers (OR = 2.21, P<.001).
- After adjusting for confounding factors, the association remained significant (OR = 1.84, P=.004).
- No significant association was found between NRTI use and cataracts or angle-closure glaucoma.
- Among HIV-negative NRTI users, no significant association with POAG was observed.
Interpretation:
The study suggests a significant association between NRTI use and increased risk of POAG, potentially linked to mitochondrial toxicity, but further research is needed to clarify the role of HIV.
Limitations:
- Retrospective design limits causal interpretation.
- Small number of HIV-negative NRTI users restricts conclusions about NRTIs independent of HIV-related factors.
Conclusion:
Prospective studies are needed to explore causality and underlying mechanisms, particularly the impact of NRTI-induced mitochondrial toxicity on glaucomatous neurodegeneration.
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