Use of NRTIs Associated with Increased Risk of Primary Open-Angle Glaucoma

Recent research indicates that the use of nucleoside and nucleotide reverse transcriptase inhibitors (NRTIs), commonly prescribed for HIV treatment, may be linked to a heightened risk of developing primary open-angle glaucoma (POAG). This association was identified through a comprehensive retrospective cohort study involving over 300,000 adults aged 40 and above, utilizing linked electronic health records from the NIH All of Us dataset.

The study, conducted by Kenneth Pham and colleagues from the University of Pennsylvania, employed a propensity score-matching method to compare 718 NRTI users with 7,180 nonusers. Results showed that 4.32% of NRTI users developed POAG, compared to just 2.00% of nonusers. The analysis revealed that NRTI use was associated with more than double the odds of developing POAG, with an odds ratio of approximately 2.21. Even after adjusting for factors like family history, HIV diagnosis, hepatitis B, and healthcare access patterns, the increased risk persisted, with an adjusted odds ratio of about 1.84.

The researchers discussed potential mechanisms behind this association. They considered that increased medical surveillance among NRTI users could lead to higher diagnosis rates; however, analyses of other eye conditions such as cataracts and angle-closure glaucoma did not support this. This suggests that the elevated POAG risk is likely linked directly to NRTI use rather than increased eye examinations.

These findings highlight a possible ocular side effect of NRTIs, signaling the need for regular eye screenings for patients on these medications. Further studies are required to understand the biological pathways involved and to develop strategies for glaucoma prevention in this patient population.

Source: https://medicalxpress.com/news/2025-07-nrti-linked-primary-angle-glaucoma.html