Association between human immunodeficiency virus infection and the risk of glaucoma: a real-world multicenter cohort...

To evaluate the association between human immunodeficiency virus (HIV) infection and the risk of developing glaucoma-related outcomes.

We conducted a population-based retrospective cohort study using the TriNetX US Network, including adults aged ≥ 20 years with ophthalmology records between January 2003 and December 2022. Individuals with preexisting ocular conditions affecting intraocular pressure, optic nerve structure, or associated with ocular neovascularization were excluded. Eligible patients were categorized based on HIV infection status. Propensity score matching was performed to balance baseline characteristics. Primary outcomes included the incidence of open-angle glaucoma (OAG), preglaucoma, ocular hypertension (OHT), initiation of antiglaucoma medications, and glaucoma-related interventional therapies during the 3-year follow-up. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

A total of 20,336 patients with HIV infection (mean age: 49.1 ± 12.1 years) were matched to 20,336 individuals without HIV (mean age: 49.2 ± 14.4 years). HIV infection was associated with higher risks of OAG (HR:4.21, 95% CI:3.36-5.28), preglaucoma (HR:2.71, 95% CI:2.46-2.99), and OHT (HR:1.38, 95% CI:1.11-1.72). HIV infection was also associated with higher risks of antiglaucoma medication initiation (3.58% vs. 2.34%; HR, 1.50; 95% CI, 1.33-1.68) and interventional therapy (1.90% vs. 0.78%; HR, 2.37; 95% CI, 1.97-2.85).

HIV infection was associated with increased risks of glaucoma-related diagnoses, as well as antiglaucoma medication initiation and interventional procedures. These findings support heightened clinical awareness and ophthalmic surveillance among patients with HIV.