Increased incidence of glaucoma medication usage in middle-aged Australian males taking antiretroviral medication - a population-based study

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Lee, W-S; Parsons, S; Cugley, D; Rogers, S; Lim, LL; Hall, ADate
2020-11-03Source Title
Journal of Ophthalmic Inflammation and InfectionPublisher
SPRINGERUniversity of Melbourne Author/s
Lim, LyndellAffiliation
Ophthalmology (Eye & Ear Hospital)Metadata
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Lee, W. -S., Parsons, S., Cugley, D., Rogers, S., Lim, L. L. & Hall, A. (2020). Increased incidence of glaucoma medication usage in middle-aged Australian males taking antiretroviral medication - a population-based study. JOURNAL OF OPHTHALMIC INFLAMMATION AND INFECTION, 10 (1), https://doi.org/10.1186/s12348-020-00218-y.Access Status
Open AccessAbstract
BACKGROUND: To investigate a possible association between glaucoma and the use of anti-retroviral therapy (ART) for HIV in the Australian population. METHODS: A retrospective review of Australian Pharmaceutical Benefits Scheme data was undertaken from July 2012 to December 2016, inclusive. Three patient groups were compared: those on both topical intraocular pressure (IOP) -lowering medication and ART, those on ART only, and those on IOP-lowering medication only, using the 2016 Australian resident population to estimate prevalence. Odds ratios (95% confidence intervals, [CI]) with Fishers exact test for p values were calculated stratified by age and gender. RESULTS: The number of prescriptions for topical glaucoma medications in the general Australian population increased progressively by age with a peak prevalence in those aged 80 years and above. Prevalence of ART was highest in males aged 40-49 and 50-59 years (0.41% [CI 0.40, 0.42] and 0.44% [CI 0.43, 0.45], respectively). Our analysis identified an increase in the prescription of IOP-lowering medication in males on ART aged 30-39 (OR 2.23 [CI 1.32, 3.75], p = 0.007) and 40-49 (OR 1.86 [CI 1.42, 2.43], p < 0.001), compared to those not on ART. There were no statistically significant increased odds for females or males aged 50 years or more. CONCLUSION: Compared with the known increase in glaucoma prevalence with age in the general Australian population, a statistically significant increased prevalence in use of IOP-lowering medications was found in males on ART aged 30-49 years. The mechanism for this is yet to be determined, but possible causes include sequelae of HIV infection, a drug-induced side effect, or increased medical surveillance.
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