JAMA Ophthalmol

Metformin use not linked to reduced risk of age-related macular degeneration

September 19, 2025

Study details: This large, multicenter retrospective cohort study (TriNetX platform, 70 institutions, 2013–2025) evaluated adults ≥65 years prescribed metformin vs. non-users. Two cohorts were analyzed:

1. Individuals without age-related macular degeneration (AMD) to assess incident AMD
2. Those with mild/moderate nonexudative AMD to assess progression to geographic atrophy or neovascular AMD

Propensity score matching controlled for confounders including age, sex, race, hypertension, diabetes, and systemic comorbidities.

Results: After matching, metformin use was associated with a modestly lower risk of developing any AMD (risk ratio [RR], 0.90; 95% confidence interval [CI], 0.86–0.94), but this didn’t meet the study’s threshold for clinical significance. Stratified analyses at 5 and 10 years showed similar results. No significant association was found between metformin use and progression to geographic atrophy (RR, 0.87; 95% CI, 0.76–1.01) or neovascular AMD (RR, 1.03; 95% CI, 0.91–1.17).

Clinical impact: The findings suggest that metformin isn’t associated with clinically meaningful reduction in AMD incidence or progression. However, authors call for further prospective studies to clarify any potential dose-response or subgroup effects.

Source:

Jindal DA, et al. (2025, September 18). JAMA Ophthalmol. Metformin and the Development of Age-Related Macular Degeneration. https://pubmed.ncbi.nlm.nih.gov/40965862/